| Nerve Renewal Group Llc | |
|
3705 Nw 63rd St Ste 101 Oklahoma City OK 73116-1937 | |
| (405) 495-9270 | |
| Not Available |
| Full Name | Nerve Renewal Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3705 Nw 63rd St Ste 101, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Tim Bales (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4054959270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nerve Renewal Group Llc 3705 Nw 63rd St Ste 200 Oklahoma City OK 73116-1937 Ph: (405) 953-7221 | Nerve Renewal Group Llc 3705 Nw 63rd St Ste 101 Oklahoma City OK 73116-1937 Ph: (405) 495-9270 |
| NPI Number | 1538839832 |
|---|---|
| Provider Enumeration Date | 09/17/2021 |
| Last Update Date | 03/03/2025 |
| Medicare PECOS PAC ID | 7416346507 |
|---|---|
| Medicare Enrollment ID | O20211110003213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538839832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Taylor Lancaster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760521645 PECOS PAC ID: 3274686373 Enrollment ID: I20120924000520 |
| Provider Name | April N Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689060725 PECOS PAC ID: 1759693674 Enrollment ID: I20150707001996 |
| Provider Name | Debra L Oday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013392737 PECOS PAC ID: 6002124161 Enrollment ID: I20151009000924 |
| Provider Name | Linda Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215552658 PECOS PAC ID: 2264887322 Enrollment ID: I20231009003245 |
| Provider Name | Ivy R Cherian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578296042 PECOS PAC ID: 5092158212 Enrollment ID: I20240205002890 |
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