MELISSA A DIETZ, MD, LLC (NPI# 1285022939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285022939 |
| Entity Type | Organization |
| Organization Name | MELISSA A DIETZ, MD, LLC |
| Practice Address |
1725 E 19th St Suite 401 Tulsa OK 74104-5437 |
| Mailing Address |
1725 E 19th St Ste 401 Tulsa OK 74104-5409 |
| Practice Telephone | 9187491413 |
| Practice Fax Number | 9187487511 |
| Mailing Telephone | 9187491413 |
| Mailing Fax Number | 9187490234 |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2018-01-12 |
| Authorized Official Name | MELISSA A DIETZ (MANAGING MEMBER) |
| Authorized Official Telephone | 9187491413 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 24521 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200125470A | 05 |
| Street Address |
1725 E 19TH ST SUITE 401 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-5437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164422408 | Alen Munson Fuller | Otolaryngology | 1725 E 19th St, Suite 100, Tulsa, OK 74104-5437 | 2005-07-28 |
| 1760918122 | Utica Women's Specialists, LLC | Obstetrics & Gynecology | 1725 E 19th St, Suite 401, Tulsa, OK 74104-5437 | 2017-05-04 |
| 1467993857 | Maleah Bloyed | Nurse Practitioner | 1725 E 19th St, Tulsa, OK 74104-5437 | 2017-03-17 |
| 1528502374 | Laura Kathryn Holman | Physician Assistant | 1725 E 19th St, Tulsa, OK 74104-5437 | 2016-12-13 |
| 1316343338 | Bryan Henry | Nurse Practitioner | 1725 E 19th St, Suite 202, Tulsa, OK 74104-5437 | 2014-11-18 |
| 1700170636 | Justin Maxwell Stone | Perfusionist | 1725 E 19th St, Suite 604, Tulsa, OK 74104-5437 | 2011-06-08 |
| 1760798490 | Joshua D. Mccann | Pharmacist | 1725 E 19th St, Ste 103, Tulsa, OK 74104-5437 | 2010-08-18 |
| 1487826608 | Drs Karlak and Martin | Internal Medicine | 1725 E 19th St, Suite 602, Tulsa, OK 74104-5437 | 2008-03-27 |
| 1861673493 | Elizabeth Kay Dolin | Internal Medicine | 1725 E 19th St, Suite 200, Tulsa, OK 74104-5437 | 2007-11-26 |
| 1679772719 | Simon A Levit, Md | Internal Medicine | 1725 E 19th St, 703, Tulsa, OK 74104-5437 | 2007-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680010 | Micah Relic | Obstetrics & Gynecology | 6465 S Yale Ave Ste 615, Tulsa, OK 74136 | 2014-04-23 |
| 1245674167 | Amanda Rae Christian | Obstetrics & Gynecology | 10507 E 91st St Ste 250, Tulsa, OK 74133-5566 | 2013-04-22 |
| 1538422423 | David Christian Cameron | Obstetrics & Gynecology | 1120 S Utica Ave Ste G100, Tulsa, OK 74104-4012 | 2012-06-17 |
| 1487930491 | Eddie Mack Abbott | Obstetrics & Gynecology | 2121 S Yorktown Ave, Apt. 601, Tulsa, OK 74114-1426 | 2011-10-24 |
| 1770874232 | Greenwood Healthcare Specialists for Women, Pllc | Obstetrics & Gynecology | 1216 E Apache St, Tulsa, OK 74106-3938 | 2011-05-02 |
| 1033350889 | Jack M. Miller | Obstetrics & Gynecology | 6406 E 108th St, Tulsa, OK 74137-8907 | 2009-03-07 |
| 1831366574 | Elizabeth Kate Couch-harris | Obstetrics & Gynecology | 6465 S Yale Ave Ste 815, Tulsa, OK 74136-7820 | 2008-05-12 |
| 1982881686 | Jennifer Gibbens Md Pllc | Obstetrics & Gynecology | 1805 E 15th St, Tulsa, OK 74104-4610 | 2008-01-24 |
| 1154487866 | Lynn E. Frame Md Inc | Obstetrics & Gynecology | 1725 E 19th St Ste 401, Tulsa, OK 74104-5409 | 2006-12-28 |
| 1154484269 | Erin Noelle Hill | Obstetrics & Gynecology | 10507 E 91st St Ste 220, Tulsa, OK 74133-5566 | 2006-12-19 |
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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.