ST. JOHN DIALYSIS, LLC (NPI# 1639255243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639255243 |
| Entity Type | Organization |
| Organization Name | ST. JOHN DIALYSIS, LLC |
| Practice Address |
1013 E Cleveland Ave Sapulpa OK 74066-4516 |
| Mailing Address |
1923 S Utica Ave Tulsa OK 74104-6520 |
| Practice Telephone | 9182273351 |
| Mailing Telephone | 9187442345 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-09-07 |
| Authorized Official Name | SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9187442180 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. JOHN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
2265 | OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BCBS | 000370114001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902984156 | St. John Dialysis, LLC | Clinic/Center | 1923 East 21st Street, Tulsa, OK 74114-1402 | 2006-11-02 |
| 1356429500 | St. John Dialysis, LLC | Clinic/Center | 1515 N Harvard Ave, Tulsa, OK 74115-4957 | 2006-11-02 |
| Street Address |
1013 E CLEVELAND AVE |
| City | SAPULPA |
| State | OK |
| Zip Code | 74066-4516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861833444 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 1013 E Cleveland Ave, Sapulpa, OK 74066-4516 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263541 | Brice Schroeder Chapa | Pharmacist | 11 W Taft, Sapulpa, OK 74066 | 2020-04-07 |
| 1902457179 | Kimberly Vandygriff | Technician | 1115 East Davis Avenue, Sapulpa, OK 74066 | 2019-09-27 |
| 1346717063 | Carla Kay Pilkington | Pharmacist | 1329 South Main St, Unit C, Sapulpa, OK 74066 | 2018-10-31 |
| 1669964433 | Kindful Hospice Sapulpa Tulsa, LLC | Hospice Care, Community Based | 1014 E Dewey Ave Ste D, Sapulpa, OK 74066 | 2018-06-06 |
| 1922492081 | Optimum Laboratory Services, LLC | Clinical Medical Laboratory | 303 East Taft Street, Suite 4, Sapulpa, OK 74066 | 2015-03-26 |
| 1568863371 | Duncan Ornelas | Case Manager/Care Coordinator | 23 Ross Ave., Sapulpa, OK 74066 | 2014-09-11 |
| 1104244417 | Carmisha Harper | Counselor | 23th E. Ross Ave., Sapulpa, OK 74066 | 2014-04-03 |
| 1699118521 | Creek Nation Health | Student in an Organized Health Care Education/Training Program | 1943 South Water, Sapulpa, OK 74066 | 2013-04-10 |
| 1487990438 | Insight Eyecare Pllc | Optometrist | 12140 S Waco Ave, Sapulpa, OK 74066 | 2012-12-19 |
| 1770847733 | Tabitha Sparks | Social Worker | 23 N. Main Street, Sapulpa, OK 74066 | 2012-06-25 |
| Find all providers in zip 74066 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861833444 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 1013 E Cleveland Ave, Sapulpa, OK 74066-4516 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043820111 | Midtown Home Dialysis LLC | Clinic/Center | 621 Nw 6th St, Oklahoma City, OK 73102-1203 | 2020-08-04 |
| 1750905733 | Bio Medical Applications of Oklahoma Inc | Clinic/Center | 324 Nw J A Richardson Loop, Ada, OK 74820-2017 | 2020-06-04 |
| 1346879640 | Fresenius Medical Care Okcd, LLC | Clinic/Center | 3012 Nw 150th St, Oklahoma City, OK 73134-2030 | 2020-04-07 |
| 1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
| 1487206595 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 215 S Brady St, Claremore, OK 74017-5081 | 2019-07-10 |
| 1104387711 | Total Renal Care, Inc. | Clinic/Center | 2 E Clark Bass Blvd Ste 101, Mcalester, OK 74501-4210 | 2019-03-27 |
| 1124509245 | Renal Treatment Centers West Inc | Clinic/Center | 6917 N May Ave, Oklahoma City, OK 73116-3238 | 2018-08-27 |
| 1811401631 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 5230 S Mingo Rd, Tulsa, OK 74146 | 2017-12-01 |
| 1356881346 | Macab Dialysis LLC | Clinic/Center | 204 S Van Buren St, Enid, OK 73703-5812 | 2017-02-24 |
| 1013455336 | Fresenius Medical Care Moore, LLC | Clinic/Center | 450 N Eastern Ave., Moore, OK 73160-5833 | 2017-02-07 |
| 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.