AHS OKLAHOMA PHYSICIAN GROUP, LLC (NPI# 1821153164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821153164 |
| Entity Type | Organization |
| Organization Name | AHS OKLAHOMA PHYSICIAN GROUP, LLC |
| Other Organization Name | MICHAEL GIETZEN, DO |
| Practice Address |
562 S Elliott St Pryor OK 74361-6411 |
| Mailing Address |
1145 S Utica Ave Suite 110 Tulsa OK 74104-4000 |
| Practice Telephone | 9188253389 |
| Practice Fax Number | 9188255505 |
| Mailing Telephone | 9185793825 |
| Mailing Fax Number | 9185791262 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT LANGLAND (CFO) |
| Authorized Official Telephone | 9185791000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Michael Gietzen, DO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821308248 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 2400 N Highway 66 Ste B, Catoosa, OK 74015-3074 | 2010-10-19 |
| 1538366083 | Ahs Oklahoma Physician Group, LLC | Internal Medicine | 9245 South Mingo, Tulsa, OK 74133 | 2007-06-28 |
| 1578760021 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 North 110th E. Ave., Owasso, OK 74055 | 2007-06-28 |
| 1982729620 | Ahs Oklahoma Physician Group, LLC | Psychiatry & Neurology | 720 W 7th St, Tulsa, OK 74127-8948 | 2007-03-20 |
| 1891850137 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 10512 N. 110th E. Ave., Owasso, OK 74055 | 2006-12-27 |
| 1588728836 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 1551 N. 9th Street, Broken Arrow, OK 74012 | 2006-12-21 |
| 1427112424 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 10512 N 110th E Ave, Owasso, OK 74055 | 2006-12-21 |
| 1710041009 | Ahs Oklahoma Physician Group, LLC | Nurse Practitioner | 2401 West Main, Henryetta, OK 74437 | 2006-12-20 |
| 1235293846 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 300 Boulder St, Pawnee, OK 74058-3801 | 2006-12-20 |
| 1548324965 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 4739 S Union Ave, Tulsa, OK 74107-7842 | 2006-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AHS OKLAHOMA PHYSICIAN GROUP, LLC | 1145 S Utica Ave Ste 115, Tulsa, OK 74104-4013 |
| Street Address |
562 S ELLIOTT ST |
| City | PRYOR |
| State | OK |
| Zip Code | 74361-6411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790719730 | Sharon Richards | Nurse Practitioner | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-07-10 |
| 1134632037 | Ahs Pryor Hospital, LLC | Clinic/Center | 562 S Elliott St, Pryor, OK 74361 | 2017-11-14 |
| 1336451004 | Sarah J Johnston | Nurse Practitioner | 562 S Elliott St, Pryor, OK 74361-6411 | 2010-07-09 |
| 1972628352 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2007-03-21 |
| 1699830935 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-27 |
| 1659435949 | Ahs Oklahoma Physician Group, LLC | Nurse Practitioner | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-20 |
| 1245394865 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-20 |
| 1912061201 | Ahs Oklahoma Physician Group, LLC | Pediatrics | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-20 |
| 1871516898 | David Roy Ring | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-07-25 |
| 1629091640 | John Fell | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787928 | Ahs Pryor Hospital, LLC | Clinic/Center | 1301 Ne 1st St Ste 400, Pryor, OK 74361 | 2018-04-12 |
| 1073029310 | Amber Bowman | Registered Nurse | 109 N. Fairland, Pryor, OK 74361 | 2017-12-22 |
| 1922361096 | Crystal Noel Parrett | Counselor | 215 N. Fairland, Pryor, OK 74361 | 2012-06-22 |
| 1447516703 | Rocky Mountain Holdings LLC | Ambulance | 591 Airport Rd, Pryor, OK 74361 | 2012-04-11 |
| 1356673180 | Tressa Fern Rice | Speech-Language Pathologist | 510 S. Elliott St. Suite C, Mayes County Speech Therapy, Pryor, OK 74361 | 2010-02-04 |
| 1083945208 | Ladena Carol Moore | Counselor | 212 S E 1st, Pryor, OK 74361 | 2010-01-28 |
| 1164753323 | Anita K Sanders | Counselor | 212 Se 1st, Pryor, OK 74361 | 2010-01-27 |
| 1619203775 | Sandra Kay Runnells | Psychologist | 109 South Fairland, Suite 101, Pryor, OK 74361 | 2009-10-26 |
| 1972838969 | Ramona L Whitehurst | Advanced Practice Midwife | 1400 Willow Road, Pryor, OK 74361 | 2009-10-08 |
| 1396971297 | Shauna Leann Jackson | Speech-Language Pathologist | 510 S. Elliott, Suite C, Pryor, OK 74361 | 2009-06-05 |
| Find all providers in zip 74361 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235302555 | S Bar D, Inc. | Family Medicine | 109 N Fairland St Ste 109, Pryor, OK 74361-4225 | 2008-04-08 |
| 1245244359 | Mary Wade Martin | Family Medicine | 211 S Mill St, Pryor, OK 74361-5221 | 2006-07-27 |
| 1699216549 | Joshua A Redmond | Family Medicine | 1301 Ne 1st St, Pryor, OK 74361-8850 | 2017-03-11 |
| 1316293020 | Mayes County Hmpn, LLC | Family Medicine | 1301 Ne 1st St, Suite 400, Pryor, OK 74361-8850 | 2012-07-31 |
| 1124399233 | Mayes County Hmpn, LLC | Family Medicine | 1301 Ne 1st St, Pryor, OK 74361-8850 | 2012-01-20 |
| 1831382472 | Joy Family Medicine | Family Medicine | 109 N Fairland St, Suite 105, Pryor, OK 74361-4203 | 2007-08-27 |
| 1699830935 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-27 |
| 1245394865 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 562 S Elliott St, Pryor, OK 74361-6411 | 2006-12-20 |
| 1649343427 | Christopher J Delong | Family Medicine | 111 N Bailey St, Pryor, OK 74361-4201 | 2006-11-17 |
| 1962425983 | Omer Raymond Nunley Jr. | Family Medicine | 133 N Fairland St, Pryor, OK 74361-4231 | 2006-07-25 |
| Find all providers in PRYOR | ||||
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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.