KELLY R FLESNER (NPI# 1073584306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073584306 |
| Entity Type | Individual |
| Full Name | KELLY R FLESNER |
| Credential | M.D. |
| Practice Address |
1265 S Utica Ave Suite 300 Tulsa OK 74104-4243 |
| Mailing Address |
9228 S Mingo Rd Suite 200 Tulsa OK 74133-5718 |
| Practice Telephone | 9185920999 |
| Practice Fax Number | 9185921021 |
| Mailing Telephone | 9185920999 |
| Mailing Fax Number | 9188782499 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2014-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 23753 | OK | Other Service Providers |
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
23753 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200023810A | 05 | |
| OK | MEDICARE RAILROAD | P00613407 | 01 |
| OK | MEDICARE RAILROAD | P00251493 | 01 |
| OK | MEDICARE PTAN | OK700120 | 01 |
| Street Address |
1265 S UTICA AVE SUITE 300 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124829 | Deanene K Tonn | Physician Assistant | 1265 S Utica Ave, Ste 300, Tulsa, OK 74104-4243 | 2005-06-17 |
| 1790318426 | Pavel Greg Buzadzhi | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2020-02-21 |
| 1447735055 | Jonathan Daniel Bouldin | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-09-28 |
| 1265910269 | Lara Madison Long | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-08-01 |
| 1760969497 | Megan L Vitrano | Clinical Nurse Specialist | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-07-25 |
| 1790262012 | Brooke Nichol Weaver | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-07-20 |
| 1013409945 | Kristopher Wayne Mcdonald | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-06-06 |
| 1942797238 | Jay W Vazquez | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-04-23 |
| 1861937013 | Kelleigh Deeann Sprott | Physician Assistant | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2016-12-27 |
| 1083071534 | Eugenia Lynn Pulliam | Physician Assistant | 1265 S Utica Ave, Suite 300, Tulsa, OK 74104-4243 | 2016-01-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659614105 | Deepa Philip | Internal Medicine | 6160 S Yale Ave Ste 200, Tulsa, OK 74136 | 2013-04-03 |
| 1700265584 | Mario Andres Bustos Rodriguez | Internal Medicine | 6160 S Yale Ave, Tulsa, OK 74136-1930 | 2015-05-26 |
| 1235579202 | Elie Abed | Internal Medicine | 9228 S Mingo Rd Ste 200, Tulsa, OK 74133 | 2013-07-04 |
| 1871813006 | Lauren Labryer | Internal Medicine | 9228 S Mingo Rd, Suite 200, Tulsa, OK 74133-5718 | 2010-06-10 |
| 1760605810 | Deborah Jan Beeson | Internal Medicine | 1705 E 19th St Ste 302, Tulsa, OK 74104-5410 | 2007-04-10 |
| 1710046156 | Laura Jane Chalmers | Internal Medicine | 4444 E 41st St, 1st Floor, Ste B, Tulsa, OK 74135-2527 | 2006-12-08 |
| 1821173568 | Maria Teresa Vargas | Internal Medicine | 6160 S Yale Ave, Tulsa, OK 74136-1930 | 2006-10-25 |
| 1356436406 | Ralph J Duda Jr. | Internal Medicine | 9228 S Mingo Rd, Suite 102, Tulsa, OK 74133-5718 | 2006-10-04 |
| 1447285978 | Sailatha Padmanabhan Thomas | Internal Medicine | 6160 S Yale Ave, Tulsa, OK 74136-1930 | 2006-07-12 |
| 1053364224 | Cristin M Bruns | Internal Medicine | 9228 S Mingo Rd, Suite 200, Tulsa, OK 74133-5718 | 2006-05-18 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.