DR. RANDALL WAYNE HENTHORN (NPI# 1508858804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508858804 |
| Entity Type | Individual |
| Full Name | DR. RANDALL WAYNE HENTHORN |
| Credential | MD |
| Practice Address |
750 Ne 13th St Oac 200 Oklahoma City OK 73104-5010 |
| Mailing Address |
1122 Ne 13th St Ori 236 Oklahoma City OK 73117-1039 |
| Practice Telephone | 4052714351 |
| Practice Fax Number | 4052718695 |
| Mailing Telephone | 4052711515 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2012-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 11470 | OK | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
11470 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BLUE CROSS BLUE SHIELD | 731069171007 | 01 |
| OK | RAILROAD MEDICARE | 050080210 | 01 |
| OK | HUMANA MILITARY | 731590295004 | 01 |
| US DEPT OF LAOR/OWCP | 352500500 | 01 |
| Street Address |
750 NE 13TH ST OAC 200 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73104-5010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384947 | Alberto J De Armendi | Anesthesiology | 750 Ne 13th St, Suite 200, Oklahoma City, OK 73104-5010 | 2005-05-23 |
| 1154981546 | Kortni Mccormick | Anesthesiology | 750 Ne 13th St, Oklahoma City, OK 73104-5010 | 2019-06-18 |
| 1962938308 | Quang Nguyen | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Oac 200, Oklahoma City, OK 73104-5010 | 2017-05-04 |
| 1992239099 | William Robert Gordon | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Oac Suite 200, Oklahoma City, OK 73104-5010 | 2017-04-14 |
| 1417481664 | Jeffrey Scott Davis | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Oklahoma City, OK 73104-5010 | 2017-04-14 |
| 1326570003 | Ciera Ward | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Oac 200, Oklahoma City, OK 73104-5010 | 2017-03-31 |
| 1346697430 | Caleb Mccormick | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Oklahoma City, OK 73104-5010 | 2016-05-18 |
| 1033563895 | Kelly Maloch | Anesthesiology | 750 Ne 13th St, Suite 200, Oklahoma City, OK 73104-5010 | 2016-04-19 |
| 1457705345 | Thomas Campbell Stevens | Student in an Organized Health Care Education/Training Program | 750 Ne 13th St, Suite 200, Oklahoma City, OK 73104-5010 | 2016-04-18 |
| 1265886154 | David Van | Anesthesiology | 750 Ne 13th St, Suite 200, Oklahoma City, OK 73104-5010 | 2016-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356979645 | Kayla Campbell | Dietitian, Registered | Stephenson Cancer Center, 800 Ne 10th Street, Oklahoma City, OK 73104 | 2020-03-31 |
| 1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
| 1265902340 | Jenna Lyn Celii | Registered Nurse | 920 Sl Young Blvd Ste 1140, Oklahoma City, OK 73104 | 2018-11-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1316433295 | Syed Muhammad Shakaib Quadri | Pathology | 940 Stanton L. Young Blvd., Bmsb 451, Oklahoma City, OK 73104 | 2018-07-03 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1417440793 | Helen Judith Turkson Apetor | Nurse Practitioner | 700 Ne 13th, Oklahoma City, OK 73104 | 2018-06-11 |
| 1003307935 | Mary Katlin Nixon | Obstetrics & Gynecology | 800 Stanton L Young Blvd Ste 2319, Oklahoma City, OK 73104 | 2018-05-26 |
| 1558851220 | Bryce Yohannan | Student in an Organized Health Care Education/Training Program | 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 | 2018-05-17 |
| 1346746690 | Kacy Anne Richburg | Orthopaedic Surgery | 711 Stanton L Young Blvd Ste 111, Oklahoma City, OK 73104 | 2018-04-04 |
| Find all providers in zip 73104 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568946846 | Medical Center Pain Clinic, LLC | Pain Medicine | 1226 N Shartel Ave Suite 300, Oklahoma City, OK 73103 | 2018-09-21 |
| 1942620604 | Joshua Marvin Woolard | Pain Medicine | 3601 Nw 138th St Ste 200, Oklahoma City, OK 73134-2513 | 2014-04-21 |
| 1497375463 | Clinilogic LLC | Pain Medicine | 3727 Nw 63rd St Ste 302, Oklahoma City, OK 73116-1931 | 2020-04-20 |
| 1245730167 | Interventional Spine Services- II, LLC | Pain Medicine | 1907 N Broadway Ave, Oklahoma City, OK 73103-4407 | 2018-02-16 |
| 1700235645 | Elite Pain & Health PC | Pain Medicine | 13100 N Western Ave Ste 200, Oklahoma City, OK 73114-1431 | 2016-06-10 |
| 1366822298 | Oklahoma Pain Physicians PC | Pain Medicine | 13301 N Meridian Ave, Bldg 600, Oklahoma City, OK 73120-9369 | 2015-06-05 |
| 1518345248 | Oklahoma Spine Hospital LLC | Pain Medicine | 14101 Parkway Commons Dr, Oklahoma City, OK 73134-6012 | 2015-05-14 |
| 1275947335 | Timothy Luke Cramer | Pain Medicine | 1226 N Shartel Ave, Suite 300, Oklahoma City, OK 73103 | 2014-06-17 |
| 1487072385 | Pro Medical Inc | Pain Medicine | 1145 Sw 74th Street, Bldg 1 Suite 300, Oklahoma City, OK 73139-2171 | 2014-03-29 |
| 1568701332 | Jack E. Marshall Md LLC | Pain Medicine | 14100 Parkway Commons Dr, Suite 100, Oklahoma City, OK 73134-6036 | 2013-02-13 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73104 |
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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.