EVOLUTION HAIR CARE,LLC (NPI# 1851847297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851847297 |
| Entity Type | Organization |
| Organization Name | EVOLUTION HAIR CARE,LLC |
| Practice Address |
11102 Stratford Dr Ste B200 Oklahoma City OK 73120-7263 |
| Mailing Address |
12429 Pittsburgh Ave Oklahoma City OK 73120-6000 |
| Practice Telephone | 4055016402 |
| Mailing Telephone | 4055016402 |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |
| Authorized Official Name | MRS. SHIRON JANEAN BULLOCK (HAIR LOSS SPECIALIST) |
| Authorized Official Telephone | 4055016402 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 94711 | OK | Agencies |
| N | 302F00000X | Exclusive Provider Organization | 94711 | OK | Managed Care Organizations |
| N | 305R00000X | Preferred Provider Organization | 94711 | OK | Managed Care Organizations |
| N | 305S00000X | Point of Service | 94711 | OK | Managed Care Organizations |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
94711 | OK | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 94711 | OK | Suppliers |
| Street Address |
11102 STRATFORD DR STE B200 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73120-7263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768971 | Nuvail Medical Services Inc | In Home Supportive Care | 3140 West Britton Road, Suite A, Oklahoma City, OK 73120 | 2019-12-26 |
| 1134781677 | Peak Solutions, LLC | Clinic/Center | 12401 Trail Oaks Drive, Therapy Room, 2nd Floor, Oklahoma City, OK 73120 | 2019-07-05 |
| 1992363881 | Laura Lynn's Home Care, LLC | Home Health | 9801 N May Ave, Oklahoma City, OK 73120 | 2019-06-05 |
| 1962992115 | Erin Lyn Florer | Occupational Therapist | 12401 Trail Oak Dr, Oklahoma City, OK 73120 | 2018-05-14 |
| 1780171009 | Diabetic Foot and Wound Center of Okfas | Podiatrist | 11100 Hefner Pointe Drive, Suite A, Oklahoma City, OK 73120 | 2018-04-23 |
| 1285134387 | Motley Vision Professionals, Pllc | Eyewear Supplier (Equipment, not the service) | 9805 N. May Avenue, Oklahoma City, OK 73120 | 2018-02-15 |
| 1043729700 | Jenna Marie Howard | Social Worker | 3301 North Meridian Ave., Building 100, Oklahoma City, OK 73120 | 2017-09-26 |
| 1962928895 | Susan Chacko | Counselor | 12000 N Virginia Avenue, Oklahoma City, OK 73120 | 2017-08-22 |
| 1023533262 | Farris Ree Stroupe | Audiologist | 4140 W. Memorial Rd Suite 116, Oklahoma City, OK 73120 | 2017-08-09 |
| 1881116200 | Rebekah Danielle Kabariti | Counselor | 12000 N. Virgnia Ave, Oklahoma City, OK 73120 | 2017-07-07 |
| Find all providers in zip 73120 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515541 | Lamoor Beauty Supply | Prosthetic/Orthotic Supplier | 2214 N Martin Luther King Ave, Oklahoma City, OK 73111-2404 | 2019-12-10 |
| 1598258378 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5601 Nw 72nd Street, Suite 257, Oklahoma City, OK 73132-5920 | 2018-06-07 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| 1881937977 | Celerity Prosthetics, LLC | Prosthetic/Orthotic Supplier | 8625 S Walker Ave, Oklahoma City, OK 73139-9462 | 2013-03-27 |
| 1427376193 | Genuine Care Rehabilitation Service Inc. | Prosthetic/Orthotic Supplier | 7510 Broadway Ext, Suite 204, Oklahoma City, OK 73116-9031 | 2010-05-05 |
| 1942490784 | Hi Fashion Wigs LLC | Prosthetic/Orthotic Supplier | 1133 North May Ave. Ss, Oklahoma City, OK 73107-5335 | 2007-07-27 |
| 1164551479 | Hair2wear, LLC | Prosthetic/Orthotic Supplier | 11624 Willow Way, Oklahoma City, OK 73162-2046 | 2007-03-04 |
| 1740366210 | Revelation Enterprises Inc | Prosthetic/Orthotic Supplier | 2122 W Reno Ave, Oklahoma City, OK 73107-7028 | 2006-10-27 |
| 1124075833 | Scott Sabolich Prosthetic & Research LLC | Prosthetic/Orthotic Supplier | 10201 Broadway Ext, Oklahoma City, OK 73114-6217 | 2006-05-28 |
| 1881672707 | Compton Shoe Inc | Prosthetic/Orthotic Supplier | 3703 Nw 50th St, Oklahoma City, OK 73112-2553 | 2006-01-03 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73120 |
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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.