RANDALL W. HENTHORN MD PC (NPI# 1851429047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851429047 |
| Entity Type | Organization |
| Organization Name | RANDALL W. HENTHORN MD PC |
| Practice Address |
520 N Meridian Ave Oklahoma City OK 73107-5723 |
| Practice Telephone | 4057369331 |
| Practice Fax Number | 4057360497 |
| Mailing Telephone | 4057369331 |
| Mailing Fax Number | 4057360497 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2010-01-26 |
| Authorized Official Name | DR. RANDALL WAYNE HENTHORN (PRESIDENT) |
| Authorized Official Telephone | 4057369331 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 11470 | OK | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL WORKERS COMP | 352500500 | 01 | |
| OK | RAILROAD MEDICARE | 050080210 | 01 |
| OK | BLUE CROSS BLUE SHIELD | 731069171007 | 01 |
| Street Address |
520 N MERIDIAN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107-5723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720314545 | Karen Teresa Oaks | Physician Assistant | 520 N Meridian Ave, Oklahoma City, OK 73107-5723 | 2009-10-29 |
| 1619196144 | Omnet Occupational Medicine | Preventive Medicine | 520 N Meridian Ave, Oklahoma City, OK 73107-5723 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932634789 | Suboxone Solutions LLC | Specialist | 10813 N Macarthur Blvd Ste W, Oklahoma City, OK 73162-6904 | 2017-04-28 |
| 1245656461 | Chris Kunkel | Specialist | 2900 Purdue Dr, Oklahoma City, OK 73128-5808 | 2014-03-12 |
| 1235554338 | Megan Peters | Specialist | 8521 N Eastern Ave, Oklahoma City, OK 73131-4031 | 2014-02-26 |
| 1821332438 | Tsa Eshelle King | Specialist | 1330 N Classen Blvd Ste 307, Oklahoma City, OK 73106-6834 | 2012-11-20 |
| 1841542859 | Tempest Johann Johnson | Specialist | 1210 Sw 77th Ter, Oklahoma City, OK 73139-2439 | 2012-10-15 |
| 1861753956 | Rickey Lee Great | Specialist | 834 Ne 36th St, Oklahoma City, OK 73105-7206 | 2012-06-05 |
| 1154689487 | Connie L Burch | Specialist | 3112 Nw Expressway Apt 115, Oklahoma City, OK 73112-4016 | 2012-04-24 |
| 1437433125 | Virginia Parrish | Specialist | 222 E Sheridan Ave, Oklahoma City, OK 73104-4233 | 2011-09-29 |
| 1356650675 | Richard C. Greyson, M.d., A Professional Corporation | Specialist | 1110 N Classen Blvd Ste 301, Oklahoma City, OK 73106-6842 | 2010-10-04 |
| 1992017420 | Maurice Upshaw Jr. | Specialist | 3035 Nw 63rd St Ste 201n, Oklahoma City, OK 73116-3606 | 2010-07-13 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
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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.