TARA GLEAVES (NPI# 1801061353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801061353 |
| Entity Type | Individual |
| Full Name | TARA GLEAVES |
| Credential | P.A. |
| Practice Address |
3500 S Western Ave Oklahoma City OK 73109-2413 |
| Practice Telephone | 4056325565 |
| Practice Fax Number | 4056323538 |
| Mailing Telephone | 4056325565 |
| Mailing Fax Number | 4056323538 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2013-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1727 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3500 S WESTERN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73109-2413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962453795 | Craig Leon Abbott | Dermatology | 3500 S Western Ave, Oklahoma City, OK 73109-2413 | 2006-05-15 |
| 1982658167 | Abbott Dermatology P C | Dermatology | 3500 S Western Ave, Oklahoma City, OK 73109-2413 | 2006-05-20 |
| 1306898986 | Randy Ray Bluethman | Physician Assistant | 3500 S Western Ave, Oklahoma City, OK 73109-2413 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905354 | Housecalls | Family Medicine | 4413 S Lee Ave, Oklahoma City, OK 73109 | 2018-06-11 |
| 1225559404 | John Nathan Jacobsen | Dentist | 235 Sw 25th St., Oklahoma City, OK 73109 | 2017-06-28 |
| 1659828648 | Cynthia Jane Laney | Registered Nurse | 4401 South Western, Oklahoma City, OK 73109 | 2016-09-07 |
| 1497104780 | Hazel Soto | Case Manager/Care Coordinator | 420 Sw, St, Oklahoma, OK 73109 | 2016-06-07 |
| 1063873677 | Ardeceley Brandi Annette Hernandez | Community/Behavioral Health | 5714 S. Western Ave, Oklahoma City, OK 73109 | 2016-03-09 |
| 1316343908 | Van Ngo | Nurse Practitioner | 4413 South Lee Ave, Oklahoma City, OK 73109 | 2014-11-10 |
| 1104249150 | Janessa Ladawn Bointy | Counselor | 5359 S. Western Ave. #707, Oklahoma City, OK 73109 | 2014-01-28 |
| 1033540299 | Bryan Graham | Case Manager/Care Coordinator | 1111 Sw 28th St, Oklahoma City, OK 73109 | 2013-12-12 |
| 1154684603 | Nubia Fiesel | Counselor | 420 Sw 10th Street, Oklahoma City, OK 73109 | 2012-06-20 |
| 1548533664 | C.c. Freeman, Md. Inc | Internal Medicine | 4221 S. Western Ave., Suite 2015, Oklahoma City, OK 73109 | 2012-02-21 |
| Find all providers in zip 73109 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| 1972042141 | Nathan Carl Kadavy | Physician Assistant | 440 N Portland Ave, Suite 1000, Oklahoma City, OK 73107-6110 | 2017-02-21 |
| 1487191946 | Neilee Wood | Physician Assistant | 8121 Nw 119th St, Oklahoma City, OK 73162-1110 | 2017-01-23 |
| 1508316530 | Shayniel Stears | Physician Assistant | 16201 Gossamer Way, Oklahoma City, OK 73165-1503 | 2016-10-13 |
| 1386016566 | D'amber Nicole Chambers | Physician Assistant | 1918 Ne 23rd St, Oklahoma City, OK 73111-3328 | 2015-10-27 |
| 1700263928 | Micaela Lupov | Physician Assistant | 101 N Robinson Ave Ste 200, Oklahoma City, OK 73102 | 2015-04-27 |
| 1710380001 | Whitney Ward | Physician Assistant | 4120 W Memorial Rd Ste 300, Oklahoma City, OK 73120-9322 | 2014-10-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73109 |
Please comment or provide details below to improve the information on TARA GLEAVES.
| 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.