THE MED SPA AT ENID LIVE WELL, PLLC (NPI# 1902437346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902437346 |
| Entity Type | Organization |
| Organization Name | THE MED SPA AT ENID LIVE WELL, PLLC |
| Practice Address |
2111 N Van Buren St Enid OK 73703-2524 |
| Practice Telephone | 5802334300 |
| Practice Fax Number | 5803506401 |
| Mailing Telephone | 5802334300 |
| Mailing Fax Number | 5803506401 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |
| Authorized Official Name | DR. VIKI SHARLAIN WHITE (CEO) |
| Authorized Official Telephone | 5802334300 |
| Authorized Official Credential | DC |
| Is Organization Subpart | Y |
| Parent Organization Name | VIKI WHITE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities | ||
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Enid Live Well | Other Name - Individual/Organization |
| Street Address |
2111 N VAN BUREN ST |
| City | ENID |
| State | OK |
| Zip Code | 73703-2524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619956554 | Viki White | Chiropractor | 2111 N Van Buren St, Enid, OK 73703-2524 | 2006-01-10 |
| 1861851750 | Radona Erin George | Nurse Practitioner | 2111 N Van Buren St, Enid, OK 73703-2524 | 2016-02-19 |
| 1851584197 | Viki White | Chiropractor | 2111 N Van Buren St, Enid, OK 73703 | 2007-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851902233 | Gena M Ford | Massage Therapist | 2117 W Owen K Garriot, Inside Beyond Beauty, Enid, OK 73703 | 2020-08-11 |
| 1396270351 | Zoom Diagnostic Imaging LLC | Clinic/Center | 1113 West Cherry Ave, Enid, OK 73703 | 2017-04-27 |
| 1083154173 | Amanda Percival, Pllc | Counselor | 1420 W Owen K. Garriott Bldg 1, Enid, OK 73703 | 2017-03-08 |
| 1972934297 | Ty Stroble | Behavioral Analyst | 408 N Oakwood, Apt.13d, Enid, OK 73703 | 2013-12-12 |
| 1801132204 | Ryan Patrick Williams | Dentist | 2510 W Chestnut Ave, Ste A, Enid, OK 73703 | 2012-12-13 |
| 1295094720 | Heather Jeanette Linder | Counselor | 2700 N. Vanburen, Trailer 240, Enid, OK 73703 | 2012-05-03 |
| 1366729477 | Karen Lynn Harris | Counselor | 1625 W. Garriot, Suite F, Enid, OK 73703 | 2011-11-03 |
| 1659666501 | Courtney Michelle Pike | Behavioral Analyst | 1625 West Owen K Garriott Road # F, Enid, OK 73703 | 2011-06-17 |
| 1194040089 | Erin K. Roberts, Dds, Plc | Dentist | 1402 N Van Buren, Enid, OK 73703 | 2010-04-02 |
| 1770812109 | Tabitha Janel Simon | Counselor | 529 North Grand, Enid, OK 73703 | 2009-12-14 |
| Find all providers in zip 73703 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659614105 | Deepa Philip | Internal Medicine | 6160 S Yale Ave Ste 200, Tulsa, OK 74136 | 2013-04-03 |
| 1457606113 | Perihan Dimachkie | Internal Medicine | 4221 S Western Ave Ste 5045, Oklahoma City, OK 73109-3450 | 2012-07-18 |
| 1487965976 | Myrto Eliades | Internal Medicine | 3433 Nw 56th St Ste 710, Oklahoma City, OK 73112-4430 | 2010-06-29 |
| 1164609046 | Bradley Dale Pittman | Internal Medicine | Ne Hwy 60, Selling, OK 73663 | 2008-01-23 |
| 1598813016 | Venkataraman Kalyanaraman | Internal Medicine | 920 Stanton L Young Blvd # 1345, Oklahoma City, OK 73104-5020 | 2007-01-08 |
| 1124138680 | Bassam Arodak | Internal Medicine | 5701 N Portland Ave Ste 220, Oklahoma City, OK 73112-1670 | 2006-08-30 |
| 1346272523 | Modhi Gude | Internal Medicine | 6001 Nw 120th Court, Ste 6, Oklahoma City, OK 73162 | 2006-07-07 |
| 1366434300 | Wynter Williams Kipgen | Internal Medicine | 809 S Walnut St, Stillwater, OK 74074-4226 | 2005-08-16 |
| 1205836061 | Thomas Seymour Henry | Internal Medicine | Route 2 Box 247, Black Hawk Health Center, Stroud, OK 74079 | 2005-07-22 |
| 1659844587 | Saints Medical Group, LLC | Internal Medicine | 6205 N Santa Fe Ave Ste 200, Oklahoma City, OK 73118-7536 | 2019-01-03 |
| Find all providers with the same taxonomy | ||||
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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.