CAMELOT CANCER CARE INC (NPI# 1396012407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396012407 |
| Entity Type | Organization |
| Organization Name | CAMELOT CANCER CARE INC |
| Practice Address |
6804 S Canton Ave Suite 110 Tulsa OK 74136-3423 |
| Practice Telephone | 9184931011 |
| Practice Fax Number | 9184931011 |
| Mailing Telephone | 9184931011 |
| Mailing Fax Number | 9184931011 |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2011-11-18 |
| Authorized Official Name | DR. LYNN KARIN JENNINGS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9184931011 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 18381 | OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | STATE OF OKLAHOMA | 18381 | 01 |
| Street Address |
6804 S CANTON AVE SUITE 110 |
| City | TULSA |
| State | OK |
| Zip Code | 74136-3423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255345583 | Christopher R Giles | Marriage & Family Therapist | 6804 S Canton Ave, Suite 120, Tulsa, OK 74136-3423 | 2006-07-29 |
| 1861032930 | Prime Care Tulsa, LLC | Chiropractor | 6804 S Canton Ave, Tulsa, OK 74136-3423 | 2020-01-07 |
| 1548340565 | Charles Miles Berry | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6804 S Canton Ave, # 110, Tulsa, OK 74136-3423 | 2006-10-16 |
| 1043309628 | Cvt Surgery, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6804 S Canton Ave, 110, Tulsa, OK 74136-3423 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912520883 | Esmeralda Rosales | Behavior Technician | 7306 S. Yale Ave, Tulsa, OK 74136 | 2020-05-26 |
| 1851939631 | Kenneth Aaron Pohl | Behavior Technician | 7107 S. Braden Ave. Suite 195, Tulsa, OK 74136 | 2019-12-12 |
| 1578109195 | Brett Ray Weaver | Chiropractor | Kelly Bldg Ste 106, 6565 S Yale Ave, Tulsa, OK 74136 | 2019-11-19 |
| 1477194488 | Adhd and Mood Center of Oklahoma | Clinic/Center | 6565 South Yale Ave, Suite 706, Tulsa, OK 74136 | 2019-10-01 |
| 1093272510 | Whitney Christine Pilkenton | Registered Nurse | 6161 S. Yale Ave., Tulsa, OK 74136 | 2019-02-21 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| 1043786304 | Saint Francis Hospital, Inc. | Hospice Care, Community Based | 6600 South Yale Ave Suite 350, Tulsa, OK 74136 | 2018-10-15 |
| 1891282877 | Premier Rheumatology of Oklahoma | Internal Medicine | 6114 E. 61st Street, Tulsa, OK 74136 | 2018-04-16 |
| 1679092175 | Grace Eloise Evans | Counselor | 6655 S. Yale Ave, Tulsa, OK 74136 | 2017-09-15 |
| 1598283756 | David Oladipo Abioye | Counselor | 7110 S Utica Avenue, Suite 613, Tulsa, OK 74136 | 2017-09-07 |
| Find all providers in zip 74136 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1356971071 | Management Worldwide, LLC | Clinic/Center | 4415 S Harvard Ave Ste 201, Tulsa, OK 74135-2618 | 2020-01-22 |
| 1477194488 | Adhd and Mood Center of Oklahoma | Clinic/Center | 6565 South Yale Ave, Suite 706, Tulsa, OK 74136 | 2019-10-01 |
| 1952957995 | Osu Center for Health Sciences | Clinic/Center | 10507 E 91st St Ste 550, Tulsa, OK 74133-5590 | 2019-08-15 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| 1437627031 | Osu Center for Health Sciences | Clinic/Center | 6475 S Yale Ave Ste 202, Tulsa, OK 74136-7819 | 2018-11-13 |
| 1063990398 | Rodi LLC | Clinic/Center | 8316 E 61st St Ste 101-aa, Tulsa, OK 74133-1910 | 2018-07-30 |
| 1134654627 | Auxarc Imc, Inc | Clinic/Center | 3421 E 21st St, Tulsa, OK 74114-1958 | 2017-04-22 |
| 1831507680 | Osu Center for Health Sciences | Clinic/Center | 5635 N Cincinnati Ave, Tulsa, OK 74126-2253 | 2014-07-24 |
| 1679996656 | Osu Center for Health Sciences | Clinic/Center | 700 N. Greenwood, #265nh, Tulsa, OK 74106-0702 | 2014-01-28 |
| 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.