ALAN LEE BROKENICKY (NPI# 1184889768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184889768 |
| Entity Type | Individual |
| Full Name | ALAN LEE BROKENICKY |
| Credential | PA |
| Practice Address |
9912 E 21st St Tulsa OK 74129-1620 |
| Mailing Address |
1705 E 19th St Ste 302 Tulsa OK 74104-5410 |
| Practice Telephone | 9186220641 |
| Mailing Telephone | 9187487585 |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2017-01-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1752 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9912 E 21ST ST |
| City | TULSA |
| State | OK |
| Zip Code | 74129-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780646984 | Corey Shawn Schoenewe | Family Medicine | 9912 E 21st St, Tulsa, OK 74129-1620 | 2006-04-04 |
| 1477639920 | Victoria Wilhelm Bjornson | Family Medicine | 9912 E 21st St, Tulsa, OK 74129-1620 | 2006-10-27 |
| 1194730911 | Community Health Connection Inc | Clinic/Center | 9912 E 21st St, Tulsa, OK 74129-1620 | 2006-07-30 |
| 1043264732 | Johnson C Gourd Jr. | Family Medicine | 9912 E 21st St, Tulsa, OK 74129-1620 | 2006-05-19 |
| 1942253935 | Janis Kay Griggs | Physician Assistant | 9912 E 21st St, Tulsa, OK 74129-1620 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114405594 | Go2therapy LLC | Counselor | 6931 E 31st Street, Unit 31, Tulsa, OK 74129 | 2018-07-30 |
| 1417472259 | Brooke Javon Denton | Physician Assistant | 2924 S. 98th East Ave, Tulsa, OK 74129 | 2017-08-12 |
| 1952459489 | Cleartone Hearing Aid Laboratories Inc | Hearing Instrument Specialist | 2323 South Sheridan, Tulsa, OK 74129 | 2007-01-08 |
| 1407879422 | Lonnie F Morris | Psychiatry & Neurology | 2316 S. Garnett, Suite E, Tulsa, OK 74129 | 2006-07-25 |
| 1902876360 | Carla Jean Pohl | Advanced Practice Midwife | 2815 S Sheridan Rd, Tulsa, OK 74129 | 2006-01-26 |
| 1710458856 | Brittany Paige Watkins | Social Worker | 11740 E 21st St, Tulsa, OK 74129 | 2018-12-16 |
| 1043799968 | Latosha Renee | Social Worker | 11740 E 21st St, Tulsa, OK 74129 | 2018-08-10 |
| 1285128710 | Amanda Danielle Woods-roberts | Social Worker | 11740 E 21st St, Tulsa, OK 74129 | 2018-06-18 |
| 1407349129 | Terri Lynne Ross | Case Manager/Care Coordinator | 11740 E 21st St, Tulsa, OK 74129 | 2018-06-07 |
| 1225529449 | Sydney Herburger | Case Manager/Care Coordinator | 11740 E 21st St, Tulsa, OK 74129 | 2018-05-23 |
| Find all providers in zip 74129 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620487 | Taehee Strauss | Physician Assistant | 5229 S Harvard Ave Apt H, Tulsa, OK 74135-3551 | 2019-10-15 |
| 1871134163 | Claire Anne Kifer | Physician Assistant | 155 E 29th Pl, Tulsa, OK 74114-5201 | 2019-10-08 |
| 1033750328 | Jazmine Denise Nicole Manns | Physician Assistant | 9132 E 37th Ct, Tulsa, OK 74145-3415 | 2019-10-08 |
| 1295376523 | Emily Montana Bergeron | Physician Assistant | 1417 W 78th St Apt 1213, Tulsa, OK 74132-4633 | 2019-10-08 |
| 1295376325 | Reagan Hahn | Physician Assistant | 7746 Riverside Pkwy Apt 203, Tulsa, OK 74136-7677 | 2019-09-30 |
| 1881245082 | Miranda Hamilton | Physician Assistant | 3726 E 43rd St, Tulsa, OK 74135-2743 | 2019-09-27 |
| 1205487493 | Christopher Thibeault | Physician Assistant | 10326 S Oswego Ave, Tulsa, OK 74137 | 2019-09-27 |
| 1831740018 | Savannah Payne | Physician Assistant | 7734 Riverside Pkwy Apt 207f, Tulsa, OK 74136-7371 | 2019-09-27 |
| 1366093759 | Garrett Blubaugh | Physician Assistant | 8307 E 60th St Apt 2127, Tulsa, OK 74145-5014 | 2019-09-26 |
| 1649821547 | Madison Snow | Physician Assistant | 7734 Riverside Pkwy # 207, Tulsa, OK 74136-7670 | 2019-09-23 |
| 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.