NORTHEASTERN OKLAHOMA ADVANCED NEUROTHERAPEUTICS LLC (NPI# 1891026902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891026902 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN OKLAHOMA ADVANCED NEUROTHERAPEUTICS LLC |
| Practice Address |
3450 E Frank Phillips Blvd Suite 100 Bartlesville OK 74006-2406 |
| Practice Telephone | 9183383781 |
| Practice Fax Number | 9183383782 |
| Mailing Telephone | 9183383781 |
| Mailing Fax Number | 9183383782 |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |
| Authorized Official Name | WALTER A LAJARA-NANSON (SOLE MEMBER) |
| Authorized Official Telephone | 9183383781 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
25610 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
3450 E FRANK PHILLIPS BLVD SUITE 100 |
| City | BARTLESVILLE |
| State | OK |
| Zip Code | 74006-2406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508884313 | Matthew L West | Family Medicine | 3450 E Frank Phillips Blvd, Suite 400, Bartlesville, OK 74006-2406 | 2006-07-18 |
| 1255815361 | Hayden Kay Lester | Nurse Practitioner | 3450 E Frank Phillips Blvd, Bartlesville, OK 74006-2406 | 2018-09-24 |
| 1912333154 | Jayme Marie Taylor | Nurse Practitioner | 3450 E Frank Phillips Blvd, Suite 400, Bartlesville, OK 74006-2406 | 2013-09-19 |
| 1659646164 | Kristie L Minor | Nurse Practitioner | 3450 E Frank Phillips Blvd, Suite 100, Bartlesville, OK 74006-2406 | 2012-03-16 |
| 1548333008 | Gemini After Hours Clinic Inc | Family Medicine | 3450 E Frank Phillips Blvd, Bartlesville, OK 74006-2406 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646252 | Ntcob LLC | Family Medicine | 234 Se De Bell Ave, Bartlesville, OK 74006 | 2020-07-06 |
| 1053936815 | Priscella Ann Caron | Nurse Practitioner | 226 Se De Bell Ave Building B, Bartlesville, OK 74006 | 2020-06-08 |
| 1508390840 | Megan Christopher | Student in an Organized Health Care Education/Training Program | 3400 Se Frank Phillips Blvd, Suite 502, Bartlesville, OK 74006 | 2017-04-13 |
| 1518339811 | Dori Raycob | Registered Nurse | 3400 Se Frank Phillips Blvd Suite 300, Bartlesville, OK 74006 | 2015-10-26 |
| 1023487436 | Katherine Marie Anderson | Nurse Practitioner | 3500 Sw Frank Phillips, Bartlesville, OK 74006 | 2015-09-16 |
| 1033593207 | Quanisha Roberson | Clinical Nurse Specialist | 226 Se De Bell Avenue, Building A, Suite 101, Bartlesville, OK 74006 | 2015-07-16 |
| 1588064604 | Vance Wayne Blackwell Jr. | Counselor | 2200 Se Washinton Blvd., Bartlesville, OK 74006 | 2014-08-26 |
| 1619314937 | Scott Ethan Sonico | Dentist | 1224 Se Washington Blvd, Bartlesville, OK 74006 | 2013-05-28 |
| 1417229485 | Vernon Lee Newby | Veterinarian | 817 Madison Blvd., Bartlesville, OK 74006 | 2012-02-06 |
| 1306083720 | Sherry M Wilson | Counselor | 3925-g Frank Phillips Blvd., Bartlesville, OK 74006 | 2009-01-08 |
| Find all providers in zip 74006 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255710117 | Jason King | Psychiatry & Neurology | 226 Se Debell Ave Ste B, Bartlesville, OK 74006-2300 | 2015-05-26 |
| 1205014248 | Jane Phillips Specialty Physicians | Psychiatry & Neurology | 226 Se Debell Ave, Bldg A, Bartlesville, OK 74006-2343 | 2008-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871110478 | Noor Mahmoud | Psychiatry & Neurology | 825 Ne 10th St Ste 5200, Oklahoma City, OK 73104-5417 | 2020-06-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1295229268 | Veronica Astrid Moreno Gomez | Psychiatry & Neurology | 920 Stanton L Young Blvd Ste Wp-2040, Oklahoma City, OK 73104-5036 | 2018-06-21 |
| 1326558180 | Comanche County Healthcare Corporation | Psychiatry & Neurology | 3201 W Gore Blvd Ste 300, Lawton, OK 73505-6350 | 2017-10-06 |
| 1033632716 | Sergio Ramirez | Psychiatry & Neurology | 920 Staton L. Young Blvd., Suite Wp-2040, Oklahoma City, OK 73104 | 2017-07-25 |
| 1407376890 | Temitope Ayodeji Lawal | Psychiatry & Neurology | 920 Stanton L Young Blvd # W2040, Oklahoma City, OK 73104-5036 | 2017-06-26 |
| 1932637030 | Marina Aleksandrovna Kravtsova | Psychiatry & Neurology | 920 Stanton L Young Blvd Ste Wp2040, Oklahoma City, OK 73104-5036 | 2017-06-01 |
| 1013379627 | Pono Neuromonitoring, Pllc | Psychiatry & Neurology | 3334 W Main St # 518, Norman, OK 73072-4805 | 2016-03-23 |
| 1508256165 | George Alexander Curry II | Psychiatry & Neurology | 9615 Prosper Dr, Oklahoma City, OK 73151-8801 | 2015-02-03 |
| 1669890612 | Varun Harishsinh Chauhan | Psychiatry & Neurology | 620 S Madison St Ste 107, Enid, OK 73701-7270 | 2014-04-06 |
| Find all providers with the same taxonomy | ||||
| City | BARTLESVILLE |
| Zip Code | 74006 |
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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.