AHS OKLAHOMA PHYSICIAN GROUP, LLC (NPI# 1215091640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215091640 |
| Entity Type | Organization |
| Organization Name | AHS OKLAHOMA PHYSICIAN GROUP, LLC |
| Other Organization Name | KATHLEEN KOLJACK, MD |
| Practice Address |
701 E Main St Jenks OK 74037-4316 |
| Mailing Address |
1145 S Utica Ave Suite 110 Tulsa OK 74104-4000 |
| Practice Telephone | 9182982264 |
| Practice Fax Number | 9182980923 |
| Mailing Telephone | 9185793825 |
| Mailing Fax Number | 9185791262 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT LANGLAND (CFO) |
| Authorized Official Telephone | 9185791000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Kathleen Koljack, MD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821308248 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 2400 N Highway 66 Ste B, Catoosa, OK 74015-3074 | 2010-10-19 |
| 1538366083 | Ahs Oklahoma Physician Group, LLC | Internal Medicine | 9245 South Mingo, Tulsa, OK 74133 | 2007-06-28 |
| 1578760021 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 North 110th E. Ave., Owasso, OK 74055 | 2007-06-28 |
| 1982729620 | Ahs Oklahoma Physician Group, LLC | Psychiatry & Neurology | 720 W 7th St, Tulsa, OK 74127-8948 | 2007-03-20 |
| 1891850137 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 10512 N. 110th E. Ave., Owasso, OK 74055 | 2006-12-27 |
| 1588728836 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 1551 N. 9th Street, Broken Arrow, OK 74012 | 2006-12-21 |
| 1427112424 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 N 110th E Ave, Owasso, OK 74055 | 2006-12-21 |
| 1710041009 | Ahs Oklahoma Physician Group, LLC | Nurse Practitioner | 2401 West Main, Henryetta, OK 74437 | 2006-12-20 |
| 1235293846 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 300 Boulder St, Pawnee, OK 74058-3801 | 2006-12-20 |
| 1548324965 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 4739 S Union Ave, Tulsa, OK 74107-7842 | 2006-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AHS OKLAHOMA PHYSICIAN GROUP, LLC | 1145 S Utica Ave Ste 115, Tulsa, OK 74104-4013 |
| Street Address |
701 E MAIN ST |
| City | JENKS |
| State | OK |
| Zip Code | 74037-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518410067 | Kayla J Hansen | Nurse Practitioner | 701 E Main St, Jenks, OK 74037-4316 | 2016-08-02 |
| 1043553902 | Kristine Elaine Bryant | Obstetrics & Gynecology | 701 E Main St, Jenks, OK 74037-4316 | 2013-03-28 |
| 1083904841 | Matthew Bryan Fowler | Family Medicine | 701 E Main St, Jenks, OK 74037-4316 | 2011-04-13 |
| 1821295379 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 701 E Main St, Jenks, OK 74037-4316 | 2007-06-28 |
| 1710192216 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 701 E Main St, Jenks, OK 74037-4316 | 2007-05-10 |
| 1538112370 | Kathleen Shepherd Koljack | Pediatrics | 701 E Main St, Jenks, OK 74037-4316 | 2006-05-19 |
| 1417942020 | Thomas Barcley Atkinson | Family Medicine | 701 E Main St, Jenks, OK 74037-4316 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437795507 | Brittanee Perez | Nurse Practitioner | 12813 South Ash Street, Jenks, OK 74037 | 2019-11-22 |
| 1790340743 | Hoppek Dental Pllc | Dentist | 202 South 2nd Street, Jenks, OK 74037 | 2019-05-06 |
| 1013570357 | Select Physical Therapy Holdings Inc. | Clinic/Center | 3402 W 114th St, Suite 101, Jenks, OK 74037 | 2019-04-22 |
| 1881170520 | Beair Medical Group, Pllc | Counselor | 201 W. Main Street, Suite 101, Jenks, OK 74037 | 2018-07-16 |
| 1336646975 | Milagros Mirdo | Nurse Practitioner | 2897 W 112th Pl S, Jenks, OK 74037 | 2018-04-10 |
| 1649779216 | Bristow Endeavor Healthcare, LLC | Pain Medicine | 512 N. Franklin Street, 2nd Floor, Jenks, OK 74037 | 2018-02-08 |
| 1114435666 | Bristow Endeavor Healthcare, LLC | Special Hospital | 3029 W. Main Street, Jenks, OK 74037 | 2018-01-18 |
| 1720590748 | Heath Bryan Coleman, Dds of Oklahoma II, Pllc | Dentist | 11476 S Union Ave, Suite 102, Jenks, OK 74037 | 2017-10-31 |
| 1245778877 | Marriage and Family Solutions, LLC | Marriage & Family Therapist | 418 East B Street, Suite A, Jenks, OK 74037 | 2017-02-02 |
| 1265975916 | Lauren Key | Case Manager/Care Coordinator | 208 Fox Run Circle, Jenks, OK 74037 | 2016-11-29 |
| Find all providers in zip 74037 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053395327 | Lisa E Hart | Pediatrics | 715 W Main St Ste S, Jenks, OK 74037-3553 | 2005-12-01 |
| 1710983952 | Melinda Dandridge | Pediatrics | 410 E Main St, Jenks, OK 74037-4135 | 2005-06-22 |
| 1538112370 | Kathleen Shepherd Koljack | Pediatrics | 701 E Main St, Jenks, OK 74037-4316 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457972366 | Saint Medical Group, LLC | Pediatrics | 3400 S Douglas Blvd Ste 307a, Oklahoma City, OK 73150-1001 | 2020-05-01 |
| 1326674177 | Premier Pediatric and Adolescent Care of Bixby | Pediatrics | 7814 E 121st St, Bixby, OK 74008 | 2020-03-12 |
| 1174180137 | Iorga Pediatrics LLC | Pediatrics | 201 N Monte Vista St Ste C, Ada, OK 74820-7220 | 2019-05-24 |
| 1851868863 | Okc Kids Urology Pllc | Pediatrics | 3705 Nw 63rd St Ste 211, Oklahoma City, OK 73116-1937 | 2018-10-28 |
| 1679067664 | Laurie Ann Alfrey | Pediatrics | 1025 E 18th St, Tulsa, OK 74120-7406 | 2018-06-21 |
| 1700380268 | Katherine Ann Brashears | Pediatrics | 6628 Fawn Canyon Dr, Oklahoma City, OK 73162-6759 | 2018-03-20 |
| 1114468436 | Vanessa Boshuizen | Pediatrics | 12020 E 31st St, Tulsa, OK 74146-2001 | 2017-03-20 |
| 1255870820 | Caitlin Schaede | Pediatrics | 601 E 13th St Ste A, Grove, OK 74344-2962 | 2017-02-15 |
| 1407390115 | Empower Pediatrics | Pediatrics | 9659 Riverside Pkwy, Tulsa, OK 74137-7398 | 2016-12-14 |
| 1528417409 | Valley Family Clinic Inc | Pediatrics | 106 Burr Ave, Pauls Valley, OK 73075-3848 | 2016-06-10 |
| 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.