ST JOSEPHS CANCER CENTER OF NORTHERN (NPI# 1770514044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770514044 |
| Entity Type | Organization |
| Organization Name | ST JOSEPHS CANCER CENTER OF NORTHERN |
| Practice Address |
609 Virginia Ave Ponca City OK 74601 |
| Mailing Address |
230 N Midwest Blvd Midwest City OK 73110 |
| Practice Telephone | 5807671300 |
| Practice Fax Number | 5807671960 |
| Mailing Telephone | 5807671300 |
| Mailing Fax Number | 5807671960 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-04-05 |
| Authorized Official Name | MR. EDWARD R GIBSON (MANAGER OPTION ONCOLOGY OKLAHOMA) |
| Authorized Official Telephone | 9494000058 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200084810A | 05 |
| Street Address |
609 VIRGINIA AVE |
| City | PONCA CITY |
| State | OK |
| Zip Code | 74601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093765224 | William J Graham | Radiology | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2006-05-10 |
| 1063069227 | Courtney Dawn Beck | Nurse Practitioner | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2019-08-22 |
| 1942598628 | Enid Urology Associates, Inc | Radiology | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2011-07-15 |
| 1033369988 | Susanna V. Ulahannan | Internal Medicine | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2008-09-29 |
| 1386722916 | Cancer & Blood Care, P.C. | Specialist | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2006-11-01 |
| 1386671584 | Troy A Richards | Radiology | 609 Virginia Ave, Ponca City, OK 74601 | 2006-06-26 |
| 1760433908 | Akinola O Ogundipe | Specialist | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245867258 | Triad Health Systems LLC | Family Medicine | 2703 N 14th St, Ponca City, OK 74601 | 2020-03-27 |
| 1679096952 | Gabrielle Evangeline Barnes | Case Manager/Care Coordinator | 620 W. Grand, Ponca City, OK 74601 | 2017-07-19 |
| 1942722889 | Kimbra Leigh Anderson | Case Manager/Care Coordinator | 1500 N. 6th, Ponca City, OK 74601 | 2017-07-12 |
| 1033631965 | Kayla Patten | Case Manager/Care Coordinator | 620 W Grand, Ponca, OK 74601 | 2017-07-12 |
| 1639601859 | Affordable Dental | Dentist | 1618 N 5th St Ste 4, Ponca City, OK 74601 | 2017-03-28 |
| 1447627237 | Harold Jason Laughlin Jr. | Chiropractor | 222 E. Grand, Ste. 309, Ponca City, OK 74601 | 2015-08-27 |
| 1578947875 | Jessica James | Social Worker | 1500 N 6th, Ponca City, OK 74601 | 2015-07-16 |
| 1639565153 | Ryian Reyes | Point of Service | 2101 N 14th, Suite 134, Ponca City, OK 74601 | 2015-04-10 |
| 1003253006 | Proving Faithful Investments Inc. | Home Health | 205 W. Hartford Avenue #112, Ponca City, OK 74601 | 2013-05-30 |
| 1427365899 | Quint Allen Whitefield | Dentist | 1618 N. 5th Street, Suite #2, Ponca City, OK 74601 | 2010-09-08 |
| Find all providers in zip 74601 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093765224 | William J Graham | Radiology | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2006-05-10 |
| 1942598628 | Enid Urology Associates, Inc | Radiology | 609 Virginia Ave, Ponca City, OK 74601-2911 | 2011-07-15 |
| 1386671584 | Troy A Richards | Radiology | 609 Virginia Ave, Ponca City, OK 74601 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942611322 | Hyperthermia Associates LLC | Radiology | 1501 N Florence Ave Ste 191, Claremore, OK 74017-3187 | 2014-05-19 |
| 1821431370 | David John Olek Jr. | Radiology | 4401 Mcauley Blvd Ste 1500, Oklahoma City, OK 73120 | 2013-04-15 |
| 1497095459 | Grove Rt Associates LLC | Radiology | 3632 Us Highway 59 N, Grove, OK 74344-3704 | 2013-02-27 |
| 1215211537 | Michael Allen Sartin | Radiology | 3236 Rock Hollow Rd, Oklahoma City, OK 73120-1928 | 2011-10-05 |
| 1578712675 | Cancer Centers of Southwest Oklahoma, LLC | Radiology | 2110 Duncan Regional Loop, Duncan, OK 73533-1568 | 2008-09-12 |
| 1720254923 | Shripal Kantilal Bhavsar | Radiology | 5911 W Memorial Rd, Oklahoma City, OK 73142-2015 | 2008-05-07 |
| 1609041136 | Cancer Centers of Southwest Oklahoma, LLC | Radiology | 1200 E Broadway St, Altus, OK 73521-5702 | 2008-04-25 |
| 1588846521 | Sakuntala Dutta | Radiology | 4908 Wisteria Dr, Oklahoma City, OK 73142-1846 | 2007-12-01 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1407927213 | Janice Hunter Witt | Radiology | 15720 Traditions Blvd, Edmond, OK 73013 | 2006-11-13 |
| Find all providers with the same taxonomy | ||||
| City | PONCA CITY |
| Zip Code | 74601 |
Please comment or provide details below to improve the information on ST JOSEPHS CANCER CENTER OF NORTHERN.
| 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.