LASE MED, INC. (NPI# 1710186994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710186994 |
| Entity Type | Organization |
| Organization Name | LASE MED, INC. |
| Practice Address |
500 N Poplar Ave Ste A Broken Arrow OK 74012-2337 |
| Mailing Address |
1894 Us Highway 50 E Ste 4 #160 Carson City NV 89701-3244 |
| Practice Telephone | 9183989577 |
| Practice Fax Number | 9183984488 |
| Mailing Telephone | 7029530267 |
| Mailing Fax Number | 7029670211 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2009-12-02 |
| Authorized Official Name | DR. ANTONELLA CARPENTER (CEO) |
| Authorized Official Telephone | 7029530267 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 3803 | OK | Managed Care Organizations |
| Street Address |
500 N POPLAR AVE STE A |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-2337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104342815 | Allied Hospice, LLC | Hospice Care, Community Based | 500 N Poplar Ave, Broken Arrow, OK 74012-2337 | 2017-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184079014 | Raphael Bonelle | Point of Service | 12201 Garden Ct, Oklahoma City, OK 73170-4006 | 2016-04-28 |
| 1972988707 | Sandra Taylor | Point of Service | 906 W 9th Pl. South, Claremore, OK 74017-0000 | 2015-07-22 |
| 1639565153 | Ryian Reyes | Point of Service | 2101 N 14th, Suite 134, Ponca City, OK 74601 | 2015-04-10 |
| 1619374337 | His Arms Extended | Point of Service | 2358 County Road 1325, Blanchard, OK 73010-3522 | 2014-11-24 |
| 1114265576 | National Practitioners Services LLC | Point of Service | 5515 E 76th St, Tulsa, OK 74136-8429 | 2013-01-19 |
| 1962752659 | United Keetoowah Band Community Health Initiative, LLC | Point of Service | 2450 S Muskogee Ave, Tahlequah, OK 74464-5450 | 2012-09-11 |
| 1649547001 | Javersak Family Chiropractic | Point of Service | 1005 Shady Holw, 1005 Shady Hollow Ct, Mcalester, OK 74501-8342 | 2011-11-29 |
| 1588984553 | Mental Health Recovery | Point of Service | 2201 Nw 122nd St Apt 513, Oklahoma City, OK 73120-8405 | 2010-06-01 |
| 1144466962 | Lifeback Chiropractic Plc | Point of Service | 1101 N Harrison St Ste B, Shawnee, OK 74801-5205 | 2008-12-29 |
| 1780858654 | J.michael Wyatt Inc.p.c. | Point of Service | 736 Nw 63rd St, Oklahoma City, OK 73116-7602 | 2008-04-22 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.