OWASSO PAIN MANAGEMENT (NPI# 1093293573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093293573 |
| Entity Type | Organization |
| Organization Name | OWASSO PAIN MANAGEMENT |
| Other Organization Name | OWASSO PAIN MANAGEMENT |
| Practice Address |
12707 E 86th St N Owasso OK 74055-2506 |
| Practice Telephone | 9182727432 |
| Practice Fax Number | 9182727448 |
| Mailing Telephone | 9182727432 |
| Mailing Fax Number | 9182727448 |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |
| Authorized Official Name | TRACY L STANDRIDGE (OWNER) |
| Authorized Official Telephone | 9182727432 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Owasso Pain Management | Doing Business As Name - Organization |
| Street Address |
12707 E 86TH ST N |
| City | OWASSO |
| State | OK |
| Zip Code | 74055-2506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033271655 | Standridge Clinic Inc | Chiropractor | 12707 E 86th St N, Owasso, OK 74055-2506 | 2006-12-14 |
| 1902106768 | Jake Wesley Landreth | Chiropractor | 12707 E 86th St N, Owasso, OK 74055-2506 | 2010-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
| Find all providers in zip 74055 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699383919 | Bdc Medical Pllc | Pain Medicine | 3101 W Tecumseh Rd Ste 102, Norman, OK 73072-1816 | 2020-07-22 |
| 1013525898 | Adaptive Pain Management LLC | Pain Medicine | 6703 E 81st St Ste E-1, Tulsa, OK 74133-4153 | 2020-07-17 |
| 1376192294 | Elite Pain & Health PC | Pain Medicine | 2020 S Service Rd, Moore, OK 73160-5512 | 2019-09-04 |
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1568946846 | Medical Center Pain Clinic, LLC | Pain Medicine | 1226 N Shartel Ave Suite 300, Oklahoma City, OK 73103 | 2018-09-21 |
| 1255810321 | Covenant Pain Management Clinic | Pain Medicine | 7615 E 63rd Pl Ste 104, Tulsa, OK 74133-1231 | 2018-08-09 |
| 1255821005 | South Tulsa Pain Management LLC. | Pain Medicine | 12345 S Memorial Dr Ste 106, Bixby, OK 74008 | 2018-05-17 |
| 1982194908 | Glenpool Pain Management LLC | Pain Medicine | 148 W Main St Ste A, Glenpool, OK 74033 | 2018-05-15 |
| 1558885749 | Western Oklahoma Pain Specialists LLC | Pain Medicine | 1901 W 3rd St Ste C, Elk City, OK 73644-4340 | 2017-07-28 |
| 1942620604 | Joshua Marvin Woolard | Pain Medicine | 3601 Nw 138th St Ste 200, Oklahoma City, OK 73134-2513 | 2014-04-21 |
| Find all providers with the same taxonomy | ||||
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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.