IVAN WAYNE (NPI# 1134198260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134198260 |
| Entity Type | Individual |
| Full Name | IVAN WAYNE |
| Credential | MD |
| Practice Address |
13904 Quailbrook Dr Oklahoma City OK 73134-1718 |
| Mailing Address |
3033 Nw 63rd St Suite 152 Oklahoma City OK 73116-3634 |
| Practice Telephone | 4057485990 |
| Practice Fax Number | 4056073580 |
| Mailing Telephone | 4057556651 |
| Mailing Fax Number | 4056073559 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2016-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 22995 | OK | Allopathic & Osteopathic Physicians |
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
22995 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
13904 QUAILBROOK DR |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73134-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306331442 | Merria Novia Dalimonte | Physician Assistant | 13904 Quailbrook Dr, Oklahoma City, OK 73134 | 2018-06-29 |
| 1649664392 | Kayla Michelle Hale | Physician Assistant | 13904 Quailbrook Dr, Oklahoma City, OK 73134-1718 | 2015-03-20 |
| 1467685560 | Charity Ann Mayhew | Physician Assistant | 13904 Quailbrook Dr, Oklahoma City, OK 73134-1718 | 2009-08-24 |
| 1679645063 | Edward A Shadid | Specialist | 13904 Quailbrook Dr, Oklahoma City, OK 73134-1702 | 2006-11-14 |
| 1487726881 | Derek J Shadid | Specialist | 13904 Quailbrook Dr, Oklahoma City, OK 73134-1702 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841846474 | Designs In Dentistry | Dentist | 14810 Serenita Ave, Oklahoma City, OK 73134 | 2019-08-09 |
| 1538683248 | Amber N Rettke | Case Manager/Care Coordinator | 14900 N. Pennsylvania Ave Apt. 1423, Oklahoma City, OK 73134 | 2017-08-03 |
| 1043750755 | Nikki Jo Rios | Behavioral Analyst | 14828 Serenita Avenue, Oklahoma City, OK 73134 | 2017-02-28 |
| 1285092437 | Christina Almstrom Whelan | Psychologist | 14616 Fossil Creek Lane, Oklahoma City, OK 73134 | 2016-02-03 |
| 1881003614 | Amber D. Given | Counselor | 14001 Mcauley Blvd. Suite 240, Oklahoma City, OK 73134 | 2014-08-06 |
| 1114365483 | Chester Arthur Woods IIi | Student in an Organized Health Care Education/Training Program | 14548 North Pennsylvania Ave, Oklahoma City, OK 73134 | 2013-06-10 |
| 1700123916 | Laura Jane Holsey | Surgery | 3543 West Memorial Road, Holsey Cosmetic Surgery & Spa, Oklahoma City, OK 73134 | 2013-01-08 |
| 1023354842 | Amattco LLC | Clinic/Center | 3705 West Memorial Rd Suite 601, Oklahoma City, OK 73134 | 2012-12-26 |
| 1740531698 | Oklahoma Sports and Orthopedics Institute Pllc | Orthopaedic Surgery | 13401 N. Western. Ave., Ste. 301, Oklahoma City, OK 73134 | 2012-10-01 |
| 1003167503 | Lindsey Brockie | Technician, Other | 14828 Serenita Ave, Oklahoma City, OK 73134 | 2012-09-24 |
| Find all providers in zip 73134 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972817054 | Scott P. Reeder | Otolaryngology | 9001 S 101st East Ave Ste 280, Tulsa, OK 74133-5711 | 2010-08-02 |
| 1356674451 | Wendy D Mcconnell | Otolaryngology | 1608 Professional Cir, Yukon, OK 73099-6314 | 2009-09-08 |
| 1285667295 | Premal Khetia | Otolaryngology | 1023 E Cherry St, Suite B, Cushing, OK 74023-4105 | 2006-07-10 |
| 1578865416 | Patrick Cody Buchanan | Otolaryngology | 800 W Boise Cir, Suite 320, Broken Arrow, OK 74012-4906 | 2010-11-29 |
| City | OKLAHOMA CITY |
| Zip Code | 73134 |
Please comment or provide details below to improve the information on IVAN WAYNE.
| 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.