OSU CENTER FOR HEALTH SCIENCES (NPI# 1316258619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316258619 |
| Entity Type | Organization |
| Organization Name | OSU CENTER FOR HEALTH SCIENCES |
| Other Organization Name | OSU-AJ CHILDERS MEDICAL GROUP |
| Practice Address |
1203 E Ross Byp Tahlequah OK 74464-4133 |
| Mailing Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Practice Telephone | 9184531234 |
| Practice Fax Number | 9184539107 |
| Mailing Telephone | 9185618306 |
| Mailing Fax Number | 9185615747 |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2010-07-01 |
| Authorized Official Name | ERIC POLAK (CFO OSU PHYSICIANS) |
| Authorized Official Telephone | 9185618322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OSU-AJ CHILDERS MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| 1447895586 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste 201, Lawton, OK 73505-6350 | 2019-11-13 |
| 1952957995 | Osu Center for Health Sciences | Clinic/Center | 10507 E 91st St Ste 550, Tulsa, OK 74133-5590 | 2019-08-15 |
| 1942852694 | Osu Center for Health Sciences | Clinic/Center | 1201 W 6th Ave, Stillwater, OK 74074-4307 | 2019-07-12 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OSU CENTER FOR HEALTH SCIENCES | 1111 W 17th St, Tulsa, OK 74107-1886 |
| Street Address |
1203 E ROSS BYP |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700875598 | Lori Lyn Enlow | Nurse Practitioner | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 | 2005-10-14 |
| 1073164125 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2019-09-20 |
| 1023311438 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 | 2010-12-08 |
| 1649584855 | Lea Sarah Humphrey | Otolaryngology | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-29 |
| 1659568301 | Cmg Family Clinic LLC | Family Medicine | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-09-26 |
| 1720274699 | Tracey W. Childers, D.o. P.C. | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2007-09-24 |
| 1730227299 | Philip Dean Watson | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-02-04 |
| 1568412310 | Susan K Anderson | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2006-05-11 |
| 1053371021 | Tracey Way Childers | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2006-03-24 |
| 1114909843 | Andrea D Mitchell | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2005-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023311438 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 | 2010-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093312548 | Prime Health Associates, Pllc | Clinic/Center | 2511 Alexa Ave, Edmond, OK 73034-3458 | 2020-10-07 |
| 1598387524 | Thomas E. Cashero Md LLC | Clinic/Center | 90 N 30th St Ste 5, Clinton, OK 73601-3100 | 2020-05-13 |
| 1184271793 | Healthy Skin Dermatology of Oklahoma Pllc | Clinic/Center | 13933 Technology Dr Ste B, Oklahoma City, OK 73134-1053 | 2019-08-20 |
| 1922572809 | Endovascular Consulting Solutions | Clinic/Center | 1705 E 19th St Ste 410, Tulsa, OK 74104-5415 | 2019-01-14 |
| 1831610641 | Scot A Sullivan Md PC | Clinic/Center | 2020 E 15th St Ste B, Edmond, OK 73013-6749 | 2017-06-30 |
| 1053862102 | Okc Neurology-catherine E Porter Md, Pllc | Clinic/Center | 6701 W Hefner Rd Ste B, Oklahoma City, OK 73162-4706 | 2016-10-24 |
| 1730584509 | Digital Diagnostic Solutions LLC | Clinic/Center | 5017 S Frontage Road, Tulsa, OK 74107-8976 | 2014-10-23 |
| 1891102331 | Panhandle Counseling and Health Center, Inc. | Clinic/Center | 5170 Patricia Blvd, Guymon, OK 73942-0000 | 2014-07-16 |
| 1922350719 | Allergy Arts of Oklahoma Pllc | Clinic/Center | 3300 Nw 56th St Ste 100, Oklahoma City, OK 73112-4538 | 2012-10-04 |
| 1255699112 | Meghan E. Scears, Md, Pllc | Clinic/Center | 808 24th Ave Nw Ste 202, Norman, OK 73069-6204 | 2012-04-30 |
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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.