AHS OKLAHOMA PHYSICIAN GROUP, LLC (NPI# 1629283114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629283114 |
| Entity Type | Organization |
| Organization Name | AHS OKLAHOMA PHYSICIAN GROUP, LLC |
| Other Organization Name | ANDREA STAFFORD, MD |
| Practice Address |
1245 S Utica Ave Tulsa OK 74104-4214 |
| Mailing Address |
1145 S Utica Ave Suite 110 Tulsa OK 74104-4000 |
| Practice Telephone | 9183822556 |
| Practice Fax Number | 9183822566 |
| Mailing Telephone | 9185793825 |
| Mailing Fax Number | 9185791262 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EARL DENNING (CFO) |
| Authorized Official Telephone | 9185791000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 25519 | OK | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Andrea Stafford, MD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821308248 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 2400 N Highway 66 Ste B, Catoosa, OK 74015-3074 | 2010-10-19 |
| 1538366083 | Ahs Oklahoma Physician Group, LLC | Internal Medicine | 9245 South Mingo, Tulsa, OK 74133 | 2007-06-28 |
| 1578760021 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 North 110th E. Ave., Owasso, OK 74055 | 2007-06-28 |
| 1982729620 | Ahs Oklahoma Physician Group, LLC | Psychiatry & Neurology | 720 W 7th St, Tulsa, OK 74127-8948 | 2007-03-20 |
| 1891850137 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 10512 N. 110th E. Ave., Owasso, OK 74055 | 2006-12-27 |
| 1588728836 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 1551 N. 9th Street, Broken Arrow, OK 74012 | 2006-12-21 |
| 1427112424 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 N 110th E Ave, Owasso, OK 74055 | 2006-12-21 |
| 1710041009 | Ahs Oklahoma Physician Group, LLC | Nurse Practitioner | 2401 West Main, Henryetta, OK 74437 | 2006-12-20 |
| 1235293846 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 300 Boulder St, Pawnee, OK 74058-3801 | 2006-12-20 |
| 1548324965 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 4739 S Union Ave, Tulsa, OK 74107-7842 | 2006-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AHS OKLAHOMA PHYSICIAN GROUP, LLC | 1145 S Utica Ave Ste 115, Tulsa, OK 74104-4013 |
| Street Address |
1245 S UTICA AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578543260 | Andre Fredieu | Psychiatry & Neurology | 1245 S Utica Ave, 3rd Floor West, Tulsa, OK 74104-4214 | 2006-01-19 |
| 1356721237 | Devon Morris | Nurse Practitioner | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2015-06-04 |
| 1124426978 | Helen Hoggard | Registered Nurse | 1245 S Utica Ave, 2nd Floor East, Tulsa, OK 74104-4214 | 2014-12-10 |
| 1306264676 | Amy Clark | Nurse Practitioner | 1245 S Utica Ave, 3rd Floor West, Tulsa, OK 74104-4214 | 2014-04-02 |
| 1811314909 | Brandi Baxter | Nurse Practitioner | 1245 S Utica Ave, Suite 103, Tulsa, OK 74104-4214 | 2014-03-26 |
| 1649612847 | Laura Thornton Bloomfield | Nurse Practitioner | 1245 S Utica Ave, 2nd Floor West, Tulsa, OK 74104-4214 | 2013-07-29 |
| 1669745667 | Amara Gayathri Nandikolla | Internal Medicine | 1245 S Utica Ave, Ste 100, Tulsa, OK 74104 | 2012-02-22 |
| 1659539401 | Hillary Pane | Family Medicine | 1245 S Utica Ave, 2w, Tulsa, OK 74104-4214 | 2008-05-29 |
| 1003001785 | Jaclyn Cinda Jones | Orthopaedic Surgery | 1245 S Utica Ave, Tulsa, OK 74104 | 2007-09-06 |
| 1477766616 | Andrea Elizabeth Stafford | Internal Medicine | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2007-05-07 |
| Find all providers in the same location | ||||
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033688270 | Results Medical Aesthetics LLC | Internal Medicine | 8014 S. 101st E. Ave., Suite 200, Tulsa, OK 74133-4580 | 2018-11-16 |
| 1598175077 | Jm Medical | Internal Medicine | 4181 Oak Rd, Tulsa, OK 74105 | 2014-05-05 |
| 1891131223 | Rebecca Thrun | Internal Medicine | 6600 S Yale Ave Ste 800, Tulsa, OK 74136 | 2013-05-13 |
| 1477811321 | Syed Tahsin Ahmed | Internal Medicine | 7356 S Trenton Ave, Tulsa, OK 74136-7357 | 2012-04-30 |
| 1861761660 | Satyabama C Johnson Sr. | Internal Medicine | 3145 East 82 Street, Ok74137, Tulsa, OK 74137 | 2011-12-22 |
| 1447541172 | Kara Marie Beair-butler | Internal Medicine | 5018 E 68th St Ste 200, Tulsa, OK 74136-3338 | 2011-04-28 |
| 1235428921 | John Charles Hervert | Internal Medicine | 9645 Riverside Pkwy Ste C, Tulsa, OK 74137-7427 | 2011-04-04 |
| 1366747149 | Zubair Ashraf | Internal Medicine | 1145 S Utica Ave Ste 1109, Tulsa, OK 74104-4010 | 2011-01-25 |
| 1679892764 | Lindsey Tricinella | Internal Medicine | 3345 S Harvard Ave Ste 201, Tulsa, OK 74135-1809 | 2010-05-27 |
| 1770800435 | South Tulsa Urgent Care LLC | Internal Medicine | 7731 E 91st St, Suite C, Tulsa, OK 74133-6022 | 2010-04-21 |
| 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.