SMALL GROUP ANESTHESIA SERVICES, LLC (NPI# 1881159085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881159085 |
| Entity Type | Organization |
| Organization Name | SMALL GROUP ANESTHESIA SERVICES, LLC |
| Practice Address |
4716 W Urbana St Broken Arrow OK 74012-5997 |
| Mailing Address |
7362 N 195th East Ave Owasso OK 74055-8219 |
| Practice Telephone | 9187045556 |
| Mailing Telephone | 9187045556 |
| Mailing Fax Number | 8665502242 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | MORGAN LEA MORGAN (BUSINESS MANAGER) |
| Authorized Official Telephone | 9187702900 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREELANCE ANESTHESIA LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4716 W URBANA ST |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-5997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376503102 | Bret Rice Haymore | Allergy & Immunology | 4716 W Urbana St, Suite 211, Broken Arrow, OK 74012-5997 | 2006-03-24 |
| 1033577085 | Osu Center for Health Sciences | Clinic/Center | 4716 W Urbana St, Suite 1, Broken Arrow, OK 74012-5997 | 2016-02-05 |
| 1073987517 | Osu Center for Health Sciences | Clinic/Center | 4716 W Urbana St, Broken Arrow, OK 74012-5997 | 2015-11-20 |
| 1053782300 | Ent and Sinus Solutions LLC | Clinic/Center | 4716 W Urbana St, Suite B, Broken Arrow, OK 74012-5997 | 2015-10-13 |
| 1487074704 | Eastern Oklahoma Oral and Maxillofacial Surgeons | Dentist | 4716 W Urbana St, Broken Arrow, OK 74012-5997 | 2014-04-25 |
| 1215254362 | Breatheamerica Tulsa, LLC | Allergy & Immunology | 4716 W Urbana St, Suite 211, Broken Arrow, OK 74012-5997 | 2010-04-29 |
| 1912221052 | D. Todd Johnson Dds, PC | Dentist | 4716 W Urbana St, Broken Arrow, OK 74012-5997 | 2010-03-18 |
| 1417187063 | Heath Harris Evans | Dentist | 4716 W Urbana St, Broken Arrow, OK 74012-5997 | 2009-07-16 |
| 1750530036 | Sherri Lynn Richardson | Nurse Practitioner | 4716 W Urbana St, Broken Arrow, OK 74012-5997 | 2008-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902429707 | Alex D Dumontier | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-05-27 |
| 1558983387 | Anna S Kim | Anesthesiologist Assistant | 3300 Nw Expwy, Oklahoma City, OK 73112-4418 | 2020-05-14 |
| 1073134144 | Parker Thomas Richardson | Anesthesiologist Assistant | 3300 Nw Expwy, Oklahoma City, OK 73112-4418 | 2020-04-30 |
| 1225657711 | Tyra M Jenkins | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-04-14 |
| 1528694148 | Savannah Schae Scott | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2020-03-15 |
| 1306481239 | Kleopatra Ruddock | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2019-11-14 |
| 1356983977 | Jason Robert Brogan | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2019-10-15 |
| 1497307144 | Cody Ryan Gaul | Anesthesiologist Assistant | 5030 N May Ave, Oklahoma City, OK 73112-6010 | 2019-07-12 |
| 1699232736 | Jordan Michael Holt | Anesthesiologist Assistant | 3300 Nw Expressway, Oklahoma City, OK 73112-4418 | 2019-02-25 |
| 1881158178 | Ellen Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.