OKLAHOMA MOBILE LITHOTRIPTER ASSOCIATES, L.C. (NPI# 1639618754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639618754 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA MOBILE LITHOTRIPTER ASSOCIATES, L.C. |
| Practice Address |
5401 N Portland Ave Suite 640 Oklahoma City OK 73112-2121 |
| Practice Telephone | 4056044160 |
| Practice Fax Number | 4056044053 |
| Mailing Telephone | 4056044160 |
| Mailing Fax Number | 4056044053 |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | STEWART BURCHETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4056044160 |
| Is Organization Subpart | Y |
| Parent Organization Name | OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QL0400X |
Clinic/Center Specialization: Lithotripsy |
Ambulatory Health Care Facilities |
| Street Address |
5401 N PORTLAND AVE SUITE 640 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306827464 | Oklahoma Surgery and Urology Center | Clinic/Center | 5401 N Portland Ave, Suite 100, Oklahoma City, OK 73112-2082 | 2005-11-07 |
| 1306397658 | Infectious Disease Associates LLC | General Acute Care Hospital | 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 | 2016-10-21 |
| 1336697432 | Grand Primary Care Clinics | Nurse Practitioner | 5401 N Portland Ave, Suite 270, Oklahoma City, OK 73112-2121 | 2016-09-17 |
| 1558735654 | Hunter's Specialty Pharmacy LLC | Pharmacy | 5401 N Portland Ave, Suite 250, Oklahoma City, OK 73112-2121 | 2015-11-30 |
| 1871960195 | Coordinated Care Health Solutions, LLC | Clinical Medical Laboratory | 5401 N Portland Ave, Suite 260, Oklahoma City, OK 73112-2121 | 2015-08-24 |
| 1952787806 | Jessica Young | Registered Nurse | 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 | 2015-08-03 |
| 1750518601 | Deaconess Physician Services LLC | Durable Medical Equipment & Medical Supplies | 5401 N Portland Ave, Suite 410, Oklahoma City, OK 73112-2121 | 2009-06-18 |
| 1982848719 | Bushra Siddique | Internal Medicine | 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 | 2009-04-23 |
| 1629223771 | Jerry R. Teel, Phd PC | Audiologist-Hearing Aid Fitter | 5401 N Portland Ave, Suite 540, Oklahoma City, OK 73112-2121 | 2008-11-17 |
| 1497926281 | Deaconess Physician Services LLC | Durable Medical Equipment & Medical Supplies | 5401 N Portland Ave, Suite 390, Oklahoma City, OK 73112-2121 | 2008-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 261QL0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Lithotripsy |
| Definition to come... |
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
Please comment or provide details below to improve the information on OKLAHOMA MOBILE LITHOTRIPTER ASSOCIATES, L.C..
| 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.