OSU CENTER FOR HEALTH SCIENCES (NPI# 1972008142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972008142 |
| Entity Type | Organization |
| Organization Name | OSU CENTER FOR HEALTH SCIENCES |
| Other Organization Name | OSU-AJ RANDALL DAVAULT, M.D. |
| Practice Address |
1706 Delivery Ln Durant OK 74701-2292 |
| Mailing Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Practice Telephone | 9185618306 |
| Practice Fax Number | 9185615747 |
| Mailing Telephone | 9185618306 |
| Mailing Fax Number | 9185615747 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | ERIC JOHN POLAK (VICE PRESIDENT FOR ADMIN/FINANCE) |
| Authorized Official Telephone | 9185618422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OSU-AJ RANDALL DAVAULT, M.D. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| 1447895586 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste 201, Lawton, OK 73505-6350 | 2019-11-13 |
| 1952957995 | Osu Center for Health Sciences | Clinic/Center | 10507 E 91st St Ste 550, Tulsa, OK 74133-5590 | 2019-08-15 |
| 1942852694 | Osu Center for Health Sciences | Clinic/Center | 1201 W 6th Ave, Stillwater, OK 74074-4307 | 2019-07-12 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OSU CENTER FOR HEALTH SCIENCES | 1111 W 17th St, Tulsa, OK 74107-1886 |
| Street Address |
1706 DELIVERY LN |
| City | DURANT |
| State | OK |
| Zip Code | 74701-2292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164478541 | Kinion Whittington | Specialist | 1706 Delivery Ln, Durant, OK 74701-2292 | 2006-05-26 |
| 1265709794 | Shyanne Roselynn Shipp | Registered Nurse | 1706 Delivery Ln, Durant, OK 74701-2292 | 2011-11-29 |
| 1316109630 | Autumn Lynn Hensley | Obstetrics & Gynecology | 1706 Delivery Ln, Durant, OK 74701-2292 | 2008-06-27 |
| 1457491904 | Randall Jason Davault | Surgery | 1706 Delivery Ln, Durant, OK 74701-2292 | 2007-02-07 |
| 1770658700 | Osu Center for Health Sciences | Clinic/Center | 1706 Delivery Ln, Durant, OK 74701-2292 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437586542 | Osu Center for Health Sciences | Clinic/Center | 1415 W Main St, Suite 300, Durant, OK 74701-4936 | 2013-10-03 |
| 1376886481 | Osu Center for Health Sciences | Clinic/Center | 702 Bryan Dr, Suite 100, Durant, OK 74701-7030 | 2013-03-27 |
| 1790022770 | Osu Center for Health Scienses | Clinic/Center | 1400 Bryan Dr, Suite 300, Durant, OK 74701-2156 | 2013-01-10 |
| 1093052078 | Osu Center for Health Sciences | Clinic/Center | 1610 W University Blvd, Durant, OK 74701-3096 | 2013-01-10 |
| 1306111984 | Peace Wellness Center, LLC | Clinic/Center | 638 Northwest Ave, Durant, MS 39063-3337 | 2012-03-15 |
| 1538335245 | Thomas J. Williams, O.d. | Clinic/Center | 203 N 16th Ave, Durant, OK 74701-3607 | 2008-05-02 |
| 1265547798 | Bryan Medical Center, LLC | Clinic/Center | 1400 Bryan Dr, Suite 211, Durant, OK 74701-2156 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1235757071 | Equality Health Group LLC | Clinic/Center | 4301 Nw 63rd St Ste 109, Oklahoma City, OK 73116-1548 | 2020-07-08 |
| 1538785985 | Stars and Stripes Therapy Inc. | Clinic/Center | 713 Sw C Ave Ste A, Lawton, OK 73501-4311 | 2020-06-22 |
| 1265058101 | Taylor Medical Group, LLP | Clinic/Center | 735 W Locust St, Stilwell, OK 74960-3403 | 2020-06-16 |
| 1891317731 | Sparks Medical Consulting LLC | Clinic/Center | 1604 Sw 38th St, Moore, OK 73160-2953 | 2020-05-14 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| 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.