DR. ASHTAMI VISHWANATH BANAVALI (NPI# 1902184518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902184518 |
| Entity Type | Individual |
| Full Name | DR. ASHTAMI VISHWANATH BANAVALI |
| Credential | MD |
| Practice Address |
430 N Monte Vista St Ada OK 74820-4610 |
| Practice Telephone | 5804211141 |
| Practice Fax Number | 5804211224 |
| Mailing Telephone | 5804211141 |
| Mailing Fax Number | 5804211224 |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2017-12-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | P26486 | MD | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
32636 | OK | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| Street Address |
430 N MONTE VISTA ST |
| City | ADA |
| State | OK |
| Zip Code | 74820-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932187606 | Fionnuala M Gurley | Internal Medicine | 430 N Monte Vista St, Ada, OK 74820-4610 | 2006-01-04 |
| 1427693787 | Payton Elizabeth Mcadams | Physician Assistant | 430 N Monte Vista St, Ada, OK 74820-4610 | 2019-11-11 |
| 1033764378 | Shannon D Krueger | Registered Nurse | 430 N Monte Vista St, Ada, OK 74820-4610 | 2019-08-05 |
| 1609438159 | Mamie Alicia Thompson | Dietitian, Registered | 430 N Monte Vista St, Ada, OK 74820-4657 | 2019-07-05 |
| 1679135446 | Ada Valley Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 430 N Monte Vista St, Ada, OK 74820-4610 | 2019-07-02 |
| 1609330968 | Justin Issac Rammage | Nurse Practitioner | 430 N Monte Vista St, Ada, OK 74820-4610 | 2019-01-30 |
| 1871085829 | Bradley Brown | Emergency Medicine | 430 N Monte Vista St, Ada, OK 74820-4610 | 2018-06-05 |
| 1093240897 | Keerthana Anand | Family Medicine | 430 N Monte Vista St, Ada, OK 74820-4610 | 2017-04-29 |
| 1528426442 | Kevin Beaver | Physician Assistant | 430 N Monte Vista St, Ada, OK 74820-4610 | 2016-02-05 |
| 1295108751 | Nicole Smith | Nurse Practitioner | 430 N Monte Vista St, Ada, OK 74820-4610 | 2015-11-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578103727 | Curry Orthopedics and Sports Medicine Pllc | Orthopaedic Surgery | 919 Colony Drive, Ada, OK 74820 | 2020-01-15 |
| 1215574603 | Miranda Denise Bowman | Counselor | 1300 Hoppe Blvd., Suite 5, Ada, OK 74820 | 2019-12-04 |
| 1326509654 | Patricia June Harjo | Case Manager/Care Coordinator | Nittak Himitta' Women's and Children's Recovery Center, 2024 Te Ata Drive, Ada, OK 74820 | 2019-03-28 |
| 1649737172 | Rylee Nikole Leblanc | Case Manager/Care Coordinator | 1119 S High School St, Ada, OK 74820 | 2019-02-20 |
| 1891251328 | David Kinback | Rehabilitation Counselor | 1400 Hoppe Blvd., Suite 3, Cn Recovery Resource Services, Ada, OK 74820 | 2019-02-20 |
| 1922571009 | Central Oklahoma Family Medical Center, Inc. | Pharmacy | 905 Colony Dr, Ada, OK 74820 | 2019-01-10 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1265907885 | Apex Surgery Center, LLC | Surgery | 2001 Cradduck Road, Ada, OK 74820 | 2018-10-10 |
| 1689150898 | Sabrina Simmons | Social Worker | 2516 Oakhurst Dr Apt E, Ada, OK 74820 | 2018-07-11 |
| 1700370467 | Brianna Leigh Youngwolfe | Nurse Practitioner | 2020 Arlington St Ste 6, Ada, OK 74820 | 2018-06-17 |
| Find all providers in zip 74820 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725302 | Saint Medical Group, LLC | Internal Medicine | 3525 Nw 56th St Ste 150c, Oklahoma City, OK 73112-4516 | 2019-02-06 |
| 1659886893 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 1614 Professional Cir, Yukon, OK 73099-6314 | 2017-12-11 |
| 1114430022 | Ssm Health Care of Oklahoma Inc | Internal Medicine | 3525 Nw 56th St Ste 100d, Oklahoma City, OK 73112-4549 | 2017-11-14 |
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1730403882 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1810 E 15th St, Tulsa, OK 74104-4611 | 2010-03-18 |
| 1851615918 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1220 W Willow Rd Ste A, Enid, OK 73703-2529 | 2010-03-18 |
| 1902137540 | Hassan Hatoum | Internal Medicine | 800 Ne 10th St. Okcc 2001-6, Stephenson Cancer Center//university of Oklahoma Health, Oklahoma City, OK 73104 | 2010-01-21 |
| 1235397654 | Agnel Rajani Raparthi | Internal Medicine | 800 Ne 10th St # 6071, Oklahoma City, OK 73104-5418 | 2008-06-02 |
| 1225229461 | Roseleen Sadruddin Charania | Internal Medicine | 1227 E 9th St, Edmond, OK 73034-5708 | 2007-08-05 |
| 1629282389 | Christopher Mark Manus | Internal Medicine | 3470 E Frank Phillips Blvd, Bartlesville, OK 74006-2406 | 2007-05-10 |
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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.