PROVISION CARES PROTON CENTER OKC, LLC (NPI# 1083109037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083109037 |
| Entity Type | Organization |
| Organization Name | PROVISION CARES PROTON CENTER OKC, LLC |
| Other Organization Name | PROVISION CARES PROTON CENTER OKC, LLC |
| Practice Address |
5901 W Memorial Rd Oklahoma City OK 73142-2015 |
| Mailing Address |
6450 Provision Cares Way Knoxville TN 37909-2544 |
| Practice Telephone | 8653424518 |
| Mailing Telephone | 8653424518 |
| Mailing Fax Number | 8653214555 |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-06-22 |
| Authorized Official Name | VALERIE GIBBS (DIRECTOR OF BUSINESS OPERATIONS) |
| Authorized Official Telephone | 8653424518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Provision Cares Proton Center OKC, LLC | Doing Business As Name - Organization |
| Street Address |
5901 W MEMORIAL RD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73142-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114964855 | Eugen B Hug | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2006-06-01 |
| 1174186175 | Proton Center Development Corporation | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2019-04-16 |
| 1114408762 | Oklahoma Proton Center LLC | Clinic/Center | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2018-08-22 |
| 1598044505 | Oklahoma Proton Radiation Oncology Group PC | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2011-08-08 |
| 1306151915 | Central Oklahoma Radiation Oncology PC | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2010-08-09 |
| 1194971960 | Oklahoma Procure Management, LLC | Clinic/Center | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2008-08-13 |
| 1255513859 | Andrew Luke Chang | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2007-12-05 |
| 1578774865 | Nancy A Cersonsky | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2007-05-25 |
| 1336235456 | Leslie T Yonemoto | Radiology | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184003790 | Advance Physicians Group LLC | Clinic/Center | 13401 N Macarthur Blvd, Oklahoma City, OK 73142 | 2015-05-28 |
| 1366840084 | Lindsey Jackson | Case Manager/Care Coordinator | 12051 Parkland Pl, Oklahoma City, OK 73142 | 2014-12-11 |
| 1164866737 | Vitality Wellness | Clinic/Center | 5740 Nw 135th St., Oklahoma City, OK 73142 | 2013-04-25 |
| 1356694558 | Joel Mitchell Sprinkle | Community Health Worker | 13100 Brandon Pl, Oklahoma City, OK 73142 | 2012-10-25 |
| 1689923856 | Sampson Mcsidney | Case Management | 14717 Hollyhock Dr, Oklahoma City, OK 73142 | 2012-09-04 |
| 1992087860 | Derek Reed Mccarver | Pharmacist | 1400 E. 2nd St, Edmond, OK 73142 | 2011-09-15 |
| 1326335811 | Laser Spine Surgery Center of Oklahoma, LLC | Clinic/Center | 4727 Gaillardia Parkway, Suite 150, Oklahoma City, OK 73142 | 2011-07-05 |
| 1215220801 | James Kenneth Fisher | Psychologist | 12522 Abbotts Way, Oklahoma City, OK 73142 | 2011-05-16 |
| 1174850408 | Diagnostic Laboratory of Oklahoma, LLC | Clinical Medical Laboratory | 5911 West Memorial Road, Oklahoma City, OK 73142 | 2009-11-06 |
| 1417113275 | Reuben Seth Thomas | Optometrist | 6200 W Memorial Rd Ste A, Oklahoma City, OK 73142 | 2008-07-31 |
| Find all providers in zip 73142 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114408762 | Oklahoma Proton Center LLC | Clinic/Center | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2018-08-22 |
| 1194971960 | Oklahoma Procure Management, LLC | Clinic/Center | 5901 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2008-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215123153 | Fep LLC | Clinic/Center | 9 N Bryant Ave, Edmond, OK 73034-6307 | 2007-09-24 |
| 1093083727 | Oncology Development Services | Clinic/Center | 2408 E 81st St, Suite 110, Tulsa, OK 74137-4200 | 2011-12-08 |
| 1992978019 | Northeast Oklahoma Cancer Center LLC | Clinic/Center | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2008-04-09 |
| 1326218033 | Eastern Oklahoma Radiation Oncology | Clinic/Center | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2008-03-10 |
| City | OKLAHOMA CITY |
| Zip Code | 73142 |
Please comment or provide details below to improve the information on PROVISION CARES PROTON CENTER OKC, LLC.
| 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.