THE SPINE AND PAIN CENTER LLC (NPI# 1689144602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689144602 |
Entity Type | Organization |
Organization Name | THE SPINE AND PAIN CENTER LLC |
Practice Address |
3336 E 32nd St Ste 220 Tulsa OK 74135-4442 |
Mailing Address |
10514 S 93rd East Ave Tulsa OK 74133-6379 |
Practice Telephone | 9182557246 |
Enumeration Date | 2018-12-03 |
Last Update Date | 2018-12-05 |
Authorized Official Name | ADAM WALLACE (OWNER) |
Authorized Official Telephone | 9182557246 |
Authorized Official Credential | MD |
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 |
3336 E 32ND ST STE 220 |
City | TULSA |
State | OK |
Zip Code | 74135-4442 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518129733 | Adam Joseph Wallace | Anesthesiology | 3336 E 32nd St Ste 220, Tulsa, OK 74135-4442 | 2008-06-29 |
1972876191 | Kala Marie Gaydos | Nurse Practitioner | 3336 E 32nd St Ste 220, Tulsa, OK 74135 | 2012-02-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437761590 | Dr. Whitney M. Ellsworth, Dpt, Pllc | Physical Therapist | 4185 S Harvard Ave, Suite E-1, Tulsa, OK 74135 | 2020-08-20 |
1942839089 | Kimberly Renee Gillens | Student in an Organized Health Care Education/Training Program | 4502 E 41st Street Obgyn Department, Tulsa, OK 74135 | 2020-04-01 |
1528525524 | Everest Pain Management | Clinic/Center | 4134 S Harvard Ave Suite B1, Tulsa, OK 74135 | 2019-02-26 |
1326524216 | Shelley Deeann Anderson | Technician | 7359 S 68th, Tulsa, OK 74135 | 2018-07-14 |
1811489065 | Taylor Diane Spears | Behavioral Analyst | 4835 S Fulton Ave Suite 104, Tulsa, OK 74135 | 2018-06-04 |
1225547821 | Heather Nicole Freed | Counselor | 4363 S Harvard Ave, Tulsa, OK 74135 | 2017-09-26 |
1306363924 | Danielle Walker | Case Manager/Care Coordinator | 3244 S Lakewood Ave Apt 4e, Tulsa, OK 74135 | 2017-08-24 |
1346766078 | Angels Place | Day Training, Developmentally Disabled Services | 3919 S. Oswego Avenue, Tulsa, OK 74135 | 2017-08-15 |
1659800019 | Welena-phay Kamamma Boren | Counselor | 4636 S Harvard Avenue, Tulsa, OK 74135 | 2017-06-08 |
1346774197 | Brandie Herren | Registered Nurse | 6333 E Skelly Drive, Tulsa, OK 74135 | 2017-04-19 |
Find all providers in zip 74135 |
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 |
1841692274 | Precision Pain Management LLC | Anesthesiology | 6717 S Yale Ave Ste 210, Tulsa, OK 74136-3328 | 2014-09-17 |
1578880225 | Patricia Eugenie Jumelle | Anesthesiology | 8131 S Memorial Dr Ste 100, Tulsa, OK 74133-4348 | 2010-04-20 |
1518129733 | Adam Joseph Wallace | Anesthesiology | 3336 E 32nd St Ste 220, Tulsa, OK 74135-4442 | 2008-06-29 |
1851581185 | Emad Samir Attallah-wasif | Anesthesiology | 10124 S Sheridan Rd, Ste B, Tulsa, OK 74133-6742 | 2007-08-01 |
1528061603 | Clinton Scott Anthony | Anesthesiology | 6802 S Olympia Ave, Suite 100, Tulsa, OK 74132-1823 | 2005-05-23 |
1902809080 | Andreas Frank Revelis | Anesthesiology | 10810 E 45th St Ste 400, Tulsa, OK 74146-3806 | 2005-05-23 |
1043835309 | Seva Pain and Wellness | Anesthesiology | 2811 E 15th St Ste 102, Tulsa, OK 74104-5242 | 2020-06-12 |
1639575160 | Uber Group Pllc | Anesthesiology | 9709 E 79th St, Tulsa, OK 74133-4566 | 2014-11-11 |
1437569639 | Ahmad Khattab | Anesthesiology | 802 S Jackson Ave Ste 310, Tulsa, OK 74127-9057 | 2014-04-28 |
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.