KAVANAH MEDICAL LLC (NPI# 1548807993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548807993 |
| Entity Type | Organization |
| Organization Name | KAVANAH MEDICAL LLC |
| Practice Address |
11560 N 135th East Ave Owasso OK 74055-5755 |
| Mailing Address |
Po Box 844 Owasso OK 74055-0844 |
| Practice Telephone | 9185531188 |
| Practice Fax Number | 9185531189 |
| Mailing Telephone | 9185531188 |
| Mailing Fax Number | 9185531189 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |
| Authorized Official Name | KRISTINA M DOOLITTLE (OWNER / NURSE PRACTITIONER) |
| Authorized Official Telephone | 9185531188 |
| Authorized Official Credential | APRN-CNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | OKLAHOMA NURSING BOARD | 95706 | 01 |
| Other Name | Type Code |
|---|---|
| Rx Health & Wellness | Doing Business As Name - Organization |
| Street Address |
11560 N 135TH EAST AVE |
| City | OWASSO |
| State | OK |
| Zip Code | 74055-5755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
| Find all providers in zip 74055 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750901682 | Robin Gail Short | Family Medicine | 9001 N 157th East Ave, Owasso, OK 74055-8545 | 2020-04-21 |
| 1548751860 | Solidaritus Health Group PC | Family Medicine | 14601 E 88th Pl N Ste 302, Owasso, OK 74055-4966 | 2018-05-22 |
| 1336690379 | Abundant Wellness | Family Medicine | 8787 N Owasso Expy, Suite J, Owasso, OK 74055-4444 | 2016-10-14 |
| 1740648211 | Stephen R Kovacs Do Pllc | Family Medicine | 8426 N 123rd East Ave, Owasso, OK 74055-2130 | 2016-01-29 |
| 1497011563 | Samantha Phoua Vang-cheng | Family Medicine | 12455 E 100th St N Ste 190, Owasso, OK 74055-4675 | 2012-04-03 |
| 1104972629 | David L & Stanley J Smith Ptrs | Family Medicine | 8510 North 123rd East Avenue, Owasso, OK 74055 | 2007-01-26 |
| 1891850137 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 10512 N. 110th E. Ave., Owasso, OK 74055 | 2006-12-27 |
| 1891723896 | Clayton David Dejarnett | Family Medicine | 10512 North 110th East Avenue, Owasso, OK 74055-6638 | 2006-06-29 |
| 1730156340 | William E Stringer | Family Medicine | 13600 E 86th St N Ste 400, Owasso, OK 74055-8732 | 2006-03-02 |
| 1215908041 | Jack Robin Snedden IIi | Family Medicine | 10502 North 110th East Avenue, Owasso, OK 74055-6655 | 2006-01-30 |
| Find all providers in OWASSO | ||||
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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.