GENESIS MEDICAL PLLC (NPI# 1578174074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578174074 |
| Entity Type | Organization |
| Organization Name | GENESIS MEDICAL PLLC |
| Practice Address |
2002 12th Ave Nw Ste B Ardmore OK 73401-1206 |
| Practice Telephone | 5802212022 |
| Practice Fax Number | 5802212024 |
| Mailing Telephone | 5802212022 |
| Mailing Fax Number | 5802212024 |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | SHERRY LYNNE CLARK (BILLING/CREDENTIALING) |
| Authorized Official Telephone | 5802235180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2002 12TH AVE NW STE B |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657590 | Advanced Pain Management Center of Oklahoma, LLC | Anesthesiology | 7107 S Yale Ave # 288, Tulsa, OK 74136-6308 | 2018-01-24 |
| 1306229422 | Morgan Vanderlick Quality Pain Management, LLC | Anesthesiology | 1916 W C St, Jenks, OK 74037-2367 | 2015-07-07 |
| 1841692274 | Precision Pain Management LLC | Anesthesiology | 6717 S Yale Ave Ste 210, Tulsa, OK 74136-3328 | 2014-09-17 |
| 1922341635 | Physician's Acupuncture, LLC | Anesthesiology | 105 S Bryant Ave Ste 404, Edmond, OK 73034-6331 | 2013-04-01 |
| 1174889778 | Sailesh Arulkumar | Anesthesiology | 535 Nw 9th St Ste 305, Oklahoma City, OK 73102 | 2012-04-09 |
| 1578880225 | Patricia Eugenie Jumelle | Anesthesiology | 8131 S Memorial Dr Ste 100, Tulsa, OK 74133-4348 | 2010-04-20 |
| 1538482146 | George Alhaj Md, PC | Anesthesiology | 517 Nw 154th St, Edmond, OK 73013-1154 | 2010-03-10 |
| 1518129733 | Adam Joseph Wallace | Anesthesiology | 3336 E 32nd St Ste 220, Tulsa, OK 74135-4442 | 2008-06-29 |
| 1851551790 | Shawn Michael Ellis | Anesthesiology | 4345 W Memorial Rd Ste 110, Oklahoma City, OK 73134-1717 | 2008-06-13 |
| 1851581185 | Emad Samir Attallah-wasif | Anesthesiology | 10124 S Sheridan Rd, Ste B, Tulsa, OK 74133-6742 | 2007-08-01 |
| Find all providers with the same taxonomy | ||||
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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.