OSU MC PROFESSIONAL SERVICES LLC (NPI# 1720417546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720417546 |
| Entity Type | Organization |
| Organization Name | OSU MC PROFESSIONAL SERVICES LLC |
| Other Organization Name | OSU MEDICAL GROUP RIVERSIDE PRIMARY CARE |
| Practice Address |
9645 Riverside Pkwy Suite C Tulsa OK 74137-7423 |
| Mailing Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Practice Telephone | 9185618306 |
| Mailing Telephone | 9185618306 |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |
| Authorized Official Name | ERIC POLAK (CFO) |
| Authorized Official Telephone | 9185618422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OSU MEDICAL GROUP RIVERSIDE PRIMARY CARE | Doing Business As Name - Organization |
| Street Address |
9645 RIVERSIDE PKWY SUITE C |
| City | TULSA |
| State | OK |
| Zip Code | 74137-7423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336451269 | Jeffrey M Stephens | Nurse Practitioner | 9645 Riverside Pkwy, Ste C, Tulsa, OK 74137-7423 | 2010-07-08 |
| 1043509474 | Britney Else | Family Medicine | 9645 Riverside Pkwy, Suite C, Tulsa, OK 74137-7423 | 2011-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487493 | Christopher Thibeault | Physician Assistant | 10326 S Oswego Ave, Tulsa, OK 74137 | 2019-09-27 |
| 1851896237 | Leslie King | Nurse Practitioner | 4809 East 89th Street South, Suite 100, Tulsa, OK 74137 | 2018-03-27 |
| 1245756428 | Olakunle Ajanaku | Dentist | 4818 East 113th Place South, Tulsa, OK 74137 | 2017-08-18 |
| 1831610096 | Cameron Craig | Dentist | 9671 South Riverside Drive East, Tulsa, OK 74137 | 2017-06-28 |
| 1669915336 | Verum Health | Chiropractor | 5014 East 101st Street, Suite 200, Tulsa, OK 74137 | 2016-11-29 |
| 1518327014 | Richard A Felmlee | General Practice | 8955 S. College Place, Tulsa, OK 74137 | 2016-02-26 |
| 1164815395 | John F Carletti Dds Prof Corp | Dentist | 2808 E. 101st St., Tulsa, OK 74137 | 2015-03-12 |
| 1023356581 | The Bair Foundation | Exclusive Provider Organization | 2921 E. 91st St, Tulsa, OK 74137 | 2013-01-17 |
| 1588900328 | Isaac Newton Causey | Counselor | 9325 S. Erie Avenue, Tulsa, OK 74137 | 2012-12-26 |
| 1952656894 | Crystal I Phillips | Behavioral Analyst | 2921 E 91st, Tulsa, OK 74137 | 2012-07-17 |
| Find all providers in zip 74137 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1356971071 | Management Worldwide, LLC | Clinic/Center | 4415 S Harvard Ave Ste 201, Tulsa, OK 74135-2618 | 2020-01-22 |
| 1477194488 | Adhd and Mood Center of Oklahoma | Clinic/Center | 6565 South Yale Ave, Suite 706, Tulsa, OK 74136 | 2019-10-01 |
| 1952957995 | Osu Center for Health Sciences | Clinic/Center | 10507 E 91st St Ste 550, Tulsa, OK 74133-5590 | 2019-08-15 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| 1437627031 | Osu Center for Health Sciences | Clinic/Center | 6475 S Yale Ave Ste 202, Tulsa, OK 74136-7819 | 2018-11-13 |
| 1063990398 | Rodi LLC | Clinic/Center | 8316 E 61st St Ste 101-aa, Tulsa, OK 74133-1910 | 2018-07-30 |
| 1134654627 | Auxarc Imc, Inc | Clinic/Center | 3421 E 21st St, Tulsa, OK 74114-1958 | 2017-04-22 |
| 1831507680 | Osu Center for Health Sciences | Clinic/Center | 5635 N Cincinnati Ave, Tulsa, OK 74126-2253 | 2014-07-24 |
| 1679996656 | Osu Center for Health Sciences | Clinic/Center | 700 N. Greenwood, #265nh, Tulsa, OK 74106-0702 | 2014-01-28 |
| 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.