ST. JOHN PHYSICIANS, INC. (NPI# 1528564929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528564929 |
| Entity Type | Organization |
| Organization Name | ST. JOHN PHYSICIANS, INC. |
| Other Organization Name | SJC OUTPATIENT DIABETES CENTER |
| Practice Address |
1717b S Utica Ave Ste 205 Tulsa OK 74104-5332 |
| Mailing Address |
1923 S Utica Ave # Dt1000 Tulsa OK 74104-6520 |
| Practice Telephone | 9187442444 |
| Practice Fax Number | 9187442483 |
| Mailing Telephone | 9187442630 |
| Mailing Fax Number | 9187442946 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Authorized Official Name | JAMES BRYAN FISSEL (DIRECTOR CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9187487617 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. JOHN PHYSICIANS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
Nursing Service Providers | ||
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| SJC Outpatient Diabetes Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245427558 | St. John Physicians, Inc. | Orthopaedic Surgery | 2000 S Wheeling Ave, Suite 900, Tulsa, OK 74104-5649 | 2007-10-01 |
| Street Address |
1717B S UTICA AVE STE 205 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-5332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952747768 | Cynthia (cyndi) A Schneider | Dietitian, Registered | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2013-05-20 |
| 1932602265 | Amber Michelle Inman | Registered Nurse | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2018-03-13 |
| 1730607060 | Tabitha Joy Sisemore | Registered Nurse | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2017-09-07 |
| 1013433077 | Caitlyn Rayann Brannon | Registered Nurse | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2017-08-21 |
| 1962928929 | Tanya Shantel Hanneman | Registered Nurse | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2017-08-21 |
| 1386160588 | Sarah Brisco | Registered Nurse | 1717b S Utica Ave Ste 205, Tulsa, OK 74104-5332 | 2017-08-18 |
| 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 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619528189 | Haley Billings | Dietitian, Registered | 1816 S Carson Ave Apt 223, Tulsa, OK 74119-5030 | 2019-09-25 |
| 1811498058 | Sydney Elyse Cavero-egusquiza | Dietitian, Registered | 4815 S Harvard Ave Ste 253, Tulsa, OK 74135-3066 | 2018-02-22 |
| 1407363773 | Aubrey Kayee Golbek | Dietitian, Registered | 1712 E 14th St, Tulsa, OK 74104-4434 | 2018-01-08 |
| 1528573862 | Tawnie Goodwin | Dietitian, Registered | 1717 S Utica Ave Ste 205, Tulsa, OK 74104-5345 | 2017-12-08 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1699298927 | Paris Delani Doty | Dietitian, Registered | 1819 E 19th St Ste 301, Tulsa, OK 74104-5407 | 2017-07-19 |
| 1528506839 | Ronda Bender | Dietitian, Registered | 6839 E 105th St, Tulsa, OK 74133-6758 | 2017-02-07 |
| 1467813428 | Amy Joyce Burden | Dietitian, Registered | 3530 E 21st Pl, Tulsa, OK 74114-1969 | 2016-03-17 |
| 1861867434 | Emily J Lawrance | Dietitian, Registered | 2000 S Wheeling Ave Ste 920, Tulsa, OK 74104 | 2015-12-08 |
| 1336539709 | Miranda Brown | Dietitian, Registered | 2517 S Harvard Pl # 17d, Tulsa, OK 74114-4638 | 2015-01-23 |
| 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.