| Omni Medical Group Inc | |
|
1923 S Utica Ave Davis Tower 200 Tulsa OK 74104-6520 | |
| (918) 744-2345 | |
| Not Available |
| Full Name | Omni Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1923 S Utica Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | William Weeks (VICE PRESIDENT) |
| Authorized Official Contact | 9187442345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Medical Group Inc 1923 S Utica Ave Davis Tower 200 Tulsa OK 74104-6520 Ph: () - | Omni Medical Group Inc 1923 S Utica Ave Davis Tower 200 Tulsa OK 74104-6520 Ph: (918) 744-2345 |
| NPI Number | 1174578249 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 12/06/2023 |
| Medicare PECOS PAC ID | 9739080490 |
|---|---|
| Medicare Enrollment ID | O20040115000897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174578249 | NPI | - | NPPES |
| 100740940A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert L Shepler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386604239 PECOS PAC ID: 5799686077 Enrollment ID: I20040119000785 |
| Provider Name | Brennon K Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073582821 PECOS PAC ID: 8426950866 Enrollment ID: I20040124000423 |
| Provider Name | William Craig Cook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891759213 PECOS PAC ID: 1355235383 Enrollment ID: I20040211000420 |
| Provider Name | Mitchell Craig Preston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417955766 PECOS PAC ID: 8820984941 Enrollment ID: I20040225000945 |
| Provider Name | Christopher J Lepak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952392185 PECOS PAC ID: 4789574484 Enrollment ID: I20040317000520 |
| Provider Name | Jacqueline M Petray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548200751 PECOS PAC ID: 9234121781 Enrollment ID: I20040402000427 |
| Provider Name | Paul T Higbee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609844703 PECOS PAC ID: 6901887702 Enrollment ID: I20040527000461 |
| Provider Name | George Bruce Carrico |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871583625 PECOS PAC ID: 1658341201 Enrollment ID: I20040729001306 |
| Provider Name | Carla M Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316021983 PECOS PAC ID: 8224076625 Enrollment ID: I20050608000146 |
| Provider Name | Stephen T Calvert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902875420 PECOS PAC ID: 9234175969 Enrollment ID: I20050830000817 |
| Provider Name | Sidney Lawler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578524260 PECOS PAC ID: 7719911882 Enrollment ID: I20051114000862 |
| Provider Name | Jill Rae Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356415574 PECOS PAC ID: 9234156019 Enrollment ID: I20051221000169 |
| Provider Name | Yvan Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518902550 PECOS PAC ID: 1153336664 Enrollment ID: I20060222000027 |
| Provider Name | Rita S Westenhaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639141724 PECOS PAC ID: 8123071586 Enrollment ID: I20060504000488 |
| Provider Name | John R Hendrix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750327581 PECOS PAC ID: 6800808296 Enrollment ID: I20060705000051 |
| Provider Name | Robert G Niebergall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912975012 PECOS PAC ID: 4183623721 Enrollment ID: I20061209000030 |
| Provider Name | James Rooks |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841269792 PECOS PAC ID: 7012918915 Enrollment ID: I20070119000199 |
| Provider Name | Afsar Emery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255391009 PECOS PAC ID: 0840392866 Enrollment ID: I20070222000211 |
| Provider Name | Omar Hawasli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801979406 PECOS PAC ID: 6800998683 Enrollment ID: I20070226000205 |
| Provider Name | Dana B Higbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336113554 PECOS PAC ID: 2466557400 Enrollment ID: I20070419000237 |
| Provider Name | Vallory J Tramonte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790826485 PECOS PAC ID: 5991801540 Enrollment ID: I20070428000071 |
| Provider Name | Lloyd T Anderson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1790823458 PECOS PAC ID: 9234235565 Enrollment ID: I20070503000288 |
| Provider Name | Teresa L Burnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932136751 PECOS PAC ID: 9335247220 Enrollment ID: I20070530000386 |
| Provider Name | Thomas B Atkinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417942020 PECOS PAC ID: 4880793587 Enrollment ID: I20070621000048 |
| Provider Name | James T Phoenix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649311309 PECOS PAC ID: 1557462546 Enrollment ID: I20070720000234 |
| Provider Name | Stanley J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487677381 PECOS PAC ID: 5092801423 Enrollment ID: I20071017000469 |
| Provider Name | David L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083637961 PECOS PAC ID: 7911093265 Enrollment ID: I20071017000741 |
| Provider Name | Enis Sakirgil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891976957 PECOS PAC ID: 9830276195 Enrollment ID: I20080410000444 |
| Provider Name | Jill L Wenger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881662013 PECOS PAC ID: 0042382087 Enrollment ID: I20080708000217 |
| Provider Name | Melody M Rachal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952319543 PECOS PAC ID: 0648343301 Enrollment ID: I20080715000081 |
| Provider Name | Suraj Suku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891833505 PECOS PAC ID: 9133293178 Enrollment ID: I20080808000395 |
| Provider Name | Asim Maqsood |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1821137050 PECOS PAC ID: 2365533932 Enrollment ID: I20081009000820 |
| Provider Name | Dustin Cupp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417113226 PECOS PAC ID: 6800956517 Enrollment ID: I20081125000111 |
| Provider Name | Stephen L Sutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972502359 PECOS PAC ID: 9133283088 Enrollment ID: I20090121000707 |
| Provider Name | Christopher R Klotz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114904000 PECOS PAC ID: 3072678457 Enrollment ID: I20090218000611 |
| Provider Name | William M James |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275591547 PECOS PAC ID: 3375521149 Enrollment ID: I20090526000408 |
| Provider Name | Hurlis V Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043289721 PECOS PAC ID: 9335287374 Enrollment ID: I20091111000280 |
| Provider Name | Lindsey M King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235367996 PECOS PAC ID: 1658410501 Enrollment ID: I20091205000145 |
| Provider Name | Brian T Crotty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003885583 PECOS PAC ID: 5597804344 Enrollment ID: I20091208000291 |
| Provider Name | Trudy Milner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649249525 PECOS PAC ID: 6800936444 Enrollment ID: I20091212000110 |
| Provider Name | Laura Beth Bilbruck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245209113 PECOS PAC ID: 5799825220 Enrollment ID: I20091215000118 |
| Provider Name | Henry G Co |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073581849 PECOS PAC ID: 3072656990 Enrollment ID: I20100201000433 |
| Provider Name | Terroll Gene Ramsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558330381 PECOS PAC ID: 1759425333 Enrollment ID: I20100219000646 |
| Provider Name | Andrew Robert Gordon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447228549 PECOS PAC ID: 5496899692 Enrollment ID: I20100225000124 |
| Provider Name | Charles M Teter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326088048 PECOS PAC ID: 9830234921 Enrollment ID: I20100301000298 |
| Provider Name | Robert Paulsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821067307 PECOS PAC ID: 9638214455 Enrollment ID: I20100304000669 |
| Provider Name | Baptiste B Shunatona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790745578 PECOS PAC ID: 3173658069 Enrollment ID: I20100317000530 |
| Provider Name | Peter B Wenger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417918806 PECOS PAC ID: 6204961105 Enrollment ID: I20100317000590 |
| Provider Name | William Thomas Hutto |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588678767 PECOS PAC ID: 0941338578 Enrollment ID: I20100503000281 |
| Provider Name | Candy L Watts |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1841525961 PECOS PAC ID: 8527196484 Enrollment ID: I20100513000553 |
| Provider Name | Ethel Vasquez-harmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922077536 PECOS PAC ID: 6204966674 Enrollment ID: I20100610000925 |
| Provider Name | Jeannette C Power |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295927234 PECOS PAC ID: 9234254301 Enrollment ID: I20100913000687 |
| Provider Name | Shivrajpal Singh Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396713483 PECOS PAC ID: 6507775798 Enrollment ID: I20100914001281 |
| Provider Name | Curtis Michael Coggins |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215906227 PECOS PAC ID: 7113042128 Enrollment ID: I20100914001302 |
| Provider Name | Harleen Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417926387 PECOS PAC ID: 1355466236 Enrollment ID: I20100915000868 |
| Provider Name | Brent W Laughlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407824501 PECOS PAC ID: 9638364789 Enrollment ID: I20101115000551 |
| Provider Name | Cynthia Ann Maloy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851356570 PECOS PAC ID: 5294735114 Enrollment ID: I20101118001173 |
| Provider Name | Kevin Eugene Steichen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881635407 PECOS PAC ID: 3476749086 Enrollment ID: I20101122000895 |
| Provider Name | Erick John Hill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508835281 PECOS PAC ID: 0941496442 Enrollment ID: I20101123000644 |
| Provider Name | Lynn M Mcclintock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366411282 PECOS PAC ID: 3173719200 Enrollment ID: I20101201000134 |
| Provider Name | Peggy Krisa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760450993 PECOS PAC ID: 2466649009 Enrollment ID: I20101209000119 |
| Provider Name | Rebecca Mae Wackowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871561001 PECOS PAC ID: 2365631249 Enrollment ID: I20110107000094 |
| Provider Name | Michael K Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336109727 PECOS PAC ID: 2961691845 Enrollment ID: I20110107000142 |
| Provider Name | Jon Pat Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114996741 PECOS PAC ID: 2769671643 Enrollment ID: I20110107000168 |
| Provider Name | R J Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083646541 PECOS PAC ID: 8426070194 Enrollment ID: I20110113000393 |
| Provider Name | Michael Kent Maxwell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346219334 PECOS PAC ID: 5597954024 Enrollment ID: I20110113000826 |
| Provider Name | Robert B Coye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215066170 PECOS PAC ID: 4385728997 Enrollment ID: I20110120000389 |
| Provider Name | Derek Matheson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780765719 PECOS PAC ID: 2668651118 Enrollment ID: I20110128001014 |
| Provider Name | Casey Snodgress |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023341443 PECOS PAC ID: 8729266937 Enrollment ID: I20110616000607 |
| Provider Name | Theron Joseph Bliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538364245 PECOS PAC ID: 0446420459 Enrollment ID: I20110831000235 |
| Provider Name | Allan Larance Suttle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861654097 PECOS PAC ID: 2860663457 Enrollment ID: I20110910002927 |
| Provider Name | Imad Uddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245498906 PECOS PAC ID: 3870764285 Enrollment ID: I20110915000274 |
| Provider Name | Maureen H Azarian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922268820 PECOS PAC ID: 7911179528 Enrollment ID: I20111004000097 |
| Provider Name | Justin Fields |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003013723 PECOS PAC ID: 7214100726 Enrollment ID: I20111028000178 |
| Provider Name | Vishal Mundra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235469503 PECOS PAC ID: 0749453926 Enrollment ID: I20111103000448 |
| Provider Name | Julia Margaret Kwon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003133463 PECOS PAC ID: 3971777152 Enrollment ID: I20111128000623 |
| Provider Name | Monica Saenz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558309278 PECOS PAC ID: 5597744169 Enrollment ID: I20120313000439 |
| Provider Name | Scott Thomas Shepherd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053569640 PECOS PAC ID: 7416113246 Enrollment ID: I20120724000308 |
| Provider Name | Jeffrey Brian Craig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497982052 PECOS PAC ID: 1951567619 Enrollment ID: I20120724000760 |
| Provider Name | Mark Hughes Crouch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851523427 PECOS PAC ID: 1759537541 Enrollment ID: I20120809000931 |
| Provider Name | Alexandria Nicole Fifer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841546637 PECOS PAC ID: 8224284989 Enrollment ID: I20120813000070 |
| Provider Name | Andrea Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922367101 PECOS PAC ID: 9032367339 Enrollment ID: I20120911000661 |
| Provider Name | Christy Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215212568 PECOS PAC ID: 2668621863 Enrollment ID: I20121003000584 |
| Provider Name | Tara Jacquelin Claussen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013240118 PECOS PAC ID: 2769633429 Enrollment ID: I20121107000038 |
| Provider Name | Aliyeah Roper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386955532 PECOS PAC ID: 8224295779 Enrollment ID: I20130212000266 |
| Provider Name | Jenny M Birks |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841537859 PECOS PAC ID: 2163314030 Enrollment ID: I20130322000352 |
| Provider Name | Lynn Tudor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386991529 PECOS PAC ID: 1052556677 Enrollment ID: I20130401000357 |
| Provider Name | Bobbie Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427495522 PECOS PAC ID: 1456590215 Enrollment ID: I20130627000089 |
| Provider Name | Ashley Hildebrand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770803660 PECOS PAC ID: 8921240136 Enrollment ID: I20130816000418 |
| Provider Name | Laura Frances Dorwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538215249 PECOS PAC ID: 4183866320 Enrollment ID: I20130816000730 |
| Provider Name | Stephen Mikus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598086050 PECOS PAC ID: 7719121938 Enrollment ID: I20130910000128 |
| Provider Name | Trang H Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790006591 PECOS PAC ID: 6406007848 Enrollment ID: I20130917000291 |
| Provider Name | Lori Ann Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013359298 PECOS PAC ID: 5698909059 Enrollment ID: I20131018000464 |
| Provider Name | Scarlet G Sparkuhl Delia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023332756 PECOS PAC ID: 2163657438 Enrollment ID: I20131023001045 |
| Provider Name | Cindy Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942571971 PECOS PAC ID: 5890920540 Enrollment ID: I20131105000590 |
| Provider Name | Romy Lee Hafner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598191215 PECOS PAC ID: 9537395850 Enrollment ID: I20131115000090 |
| Provider Name | Katelynne Jean Yow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265854624 PECOS PAC ID: 0042441396 Enrollment ID: I20140329000280 |
| Provider Name | Kelsey Ray Schumacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245657378 PECOS PAC ID: 0042435992 Enrollment ID: I20140709000094 |
| Provider Name | David Polizzi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386933992 PECOS PAC ID: 6103058581 Enrollment ID: I20140819001134 |
| Provider Name | Ashley Pojezny |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174966048 PECOS PAC ID: 2062736606 Enrollment ID: I20150130000879 |
| Provider Name | Merry Huber |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1720499585 PECOS PAC ID: 2860710894 Enrollment ID: I20150423000246 |
| Provider Name | Makeda Sharell Gant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003201039 PECOS PAC ID: 3072832740 Enrollment ID: I20150430000695 |
| Provider Name | Terry Mills |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396772182 PECOS PAC ID: 0244282341 Enrollment ID: I20150624000882 |
| Provider Name | Rapha A Wiley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932493178 PECOS PAC ID: 0749508950 Enrollment ID: I20150805008020 |
| Provider Name | Jeannette Elaine Windschitl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396122800 PECOS PAC ID: 9032426283 Enrollment ID: I20150921001135 |
| Provider Name | Ana Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407237530 PECOS PAC ID: 4587972963 Enrollment ID: I20151005001549 |
| Provider Name | Warren Hancock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902196728 PECOS PAC ID: 9436380581 Enrollment ID: I20151006001220 |
| Provider Name | Jacquelyn Ann Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326414947 PECOS PAC ID: 1759690738 Enrollment ID: I20151013001634 |
| Provider Name | Paul Andrew Cromer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346623980 PECOS PAC ID: 9032428099 Enrollment ID: I20151014002453 |
| Provider Name | Kelly R Wratten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346652930 PECOS PAC ID: 9739309956 Enrollment ID: I20151016001926 |
| Provider Name | Rebecca Thrun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891131223 PECOS PAC ID: 0446550958 Enrollment ID: I20151204000496 |
| Provider Name | Mitzi Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053770404 PECOS PAC ID: 0143519678 Enrollment ID: I20160523001075 |
| Provider Name | Travis J Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386985869 PECOS PAC ID: 0143513937 Enrollment ID: I20160802000340 |
| Provider Name | Samantha Phoua Vang-cheng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497011563 PECOS PAC ID: 6002101789 Enrollment ID: I20160819000279 |
| Provider Name | Jenny Lessley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720321474 PECOS PAC ID: 0143515841 Enrollment ID: I20160819000795 |
| Provider Name | Kendra Krahenbuhl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093150096 PECOS PAC ID: 1759676984 Enrollment ID: I20160826000212 |
| Provider Name | Jennifer Vanderford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356799142 PECOS PAC ID: 4587950936 Enrollment ID: I20160910000226 |
| Provider Name | Jeremy Ransdell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346627395 PECOS PAC ID: 8820384076 Enrollment ID: I20160914001302 |
| Provider Name | Adam Greer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184001133 PECOS PAC ID: 0446546600 Enrollment ID: I20160914001750 |
| Provider Name | Natalie Kay Hearn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396054250 PECOS PAC ID: 7911263413 Enrollment ID: I20171116002226 |
| Provider Name | Annie Alex |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891172847 PECOS PAC ID: 2365709573 Enrollment ID: I20171127000517 |
| Provider Name | Leisa Carrol Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851468516 PECOS PAC ID: 3072870948 Enrollment ID: I20171130002411 |
| Provider Name | Gina Leanne Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215952742 PECOS PAC ID: 8325088693 Enrollment ID: I20171201000913 |
| Provider Name | Rachel Rene Stockwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487938122 PECOS PAC ID: 0840465829 Enrollment ID: I20171205003489 |
| Provider Name | Kristina Marie Doolittle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306353552 PECOS PAC ID: 4284995952 Enrollment ID: I20180221002317 |
| Provider Name | Sarah Renea Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417453853 PECOS PAC ID: 2062767247 Enrollment ID: I20180611002464 |
| Provider Name | Timothy Bushyhead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154718807 PECOS PAC ID: 8123379419 Enrollment ID: I20180926000547 |
| Provider Name | Adam D Helm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073091062 PECOS PAC ID: 6709130222 Enrollment ID: I20181119001828 |
| Provider Name | Goldameir Akingbola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033592548 PECOS PAC ID: 1850645169 Enrollment ID: I20181126000869 |
| Provider Name | Samuel Mark Kammerzell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902293103 PECOS PAC ID: 8022362359 Enrollment ID: I20181126001687 |
| Provider Name | Cynthia Kay Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285988436 PECOS PAC ID: 9739424896 Enrollment ID: I20181218000608 |
| Provider Name | Jamie Larie Kitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124532890 PECOS PAC ID: 9638414329 Enrollment ID: I20181228000509 |
| Provider Name | Monica Ann Kirkendoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750821658 PECOS PAC ID: 6103162227 Enrollment ID: I20190110002655 |
| Provider Name | Jasmine Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578801361 PECOS PAC ID: 6901143221 Enrollment ID: I20190124002437 |
| Provider Name | Erin Molly Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639641202 PECOS PAC ID: 5597006502 Enrollment ID: I20190401000450 |
| Provider Name | Courtney Dawn Schrader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992278337 PECOS PAC ID: 6103159660 Enrollment ID: I20190614002368 |
| Provider Name | Sandra Elaine Crain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396249348 PECOS PAC ID: 2567796501 Enrollment ID: I20190626000550 |
| Provider Name | Shantel Laniece Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487112603 PECOS PAC ID: 3173857737 Enrollment ID: I20190702000646 |
| Provider Name | Lauren E Mendicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275098873 PECOS PAC ID: 6901134394 Enrollment ID: I20190822003308 |
| Provider Name | David Richard Herrmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629565627 PECOS PAC ID: 6800126764 Enrollment ID: I20190919002747 |
| Provider Name | Gretchen Kay Casci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407324999 PECOS PAC ID: 2365772076 Enrollment ID: I20190924000009 |
| Provider Name | Courtney Elizabeth Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285292003 PECOS PAC ID: 0244560563 Enrollment ID: I20190927003001 |
| Provider Name | Patricia Duffy-feins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093044851 PECOS PAC ID: 1759612161 Enrollment ID: I20191016003151 |
| Provider Name | Kelsey Donnette Kruckeberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356994974 PECOS PAC ID: 9830421551 Enrollment ID: I20191030002028 |
| Provider Name | Misty Dawn Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235787672 PECOS PAC ID: 4880027176 Enrollment ID: I20191126002820 |
| Provider Name | Cedric Michael Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194216176 PECOS PAC ID: 9537593652 Enrollment ID: I20191226001355 |
| Provider Name | Michaelle L Holbird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548822794 PECOS PAC ID: 4385072230 Enrollment ID: I20200309000252 |
| Provider Name | Jan Byerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659917227 PECOS PAC ID: 8527496124 Enrollment ID: I20200313001011 |
| Provider Name | Christina Dawn Tinsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841848975 PECOS PAC ID: 0941639975 Enrollment ID: I20200326002181 |
| Provider Name | Michelle Lynn Isaacs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669014619 PECOS PAC ID: 3173952827 Enrollment ID: I20200401002872 |
| Provider Name | Mary Camille Chelf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821617077 PECOS PAC ID: 9234554528 Enrollment ID: I20200804000737 |
| Provider Name | Natalie Summerlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023006343 PECOS PAC ID: 6901796291 Enrollment ID: I20200812001438 |
| Provider Name | Herman Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346779816 PECOS PAC ID: 7416227996 Enrollment ID: I20200818002851 |
| Provider Name | Michelle L Critchfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801425103 PECOS PAC ID: 5890115307 Enrollment ID: I20201022002374 |
| Provider Name | Danielle Nicole Strohmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275156010 PECOS PAC ID: 3678984499 Enrollment ID: I20201201000529 |
| Provider Name | Tonya Nicole Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073194742 PECOS PAC ID: 2062820319 Enrollment ID: I20210426002438 |
| Provider Name | Talisha L Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821564212 PECOS PAC ID: 4486992880 Enrollment ID: I20210617003034 |
| Provider Name | Ryan J Wenzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750871141 PECOS PAC ID: 9638427693 Enrollment ID: I20210825002224 |
| Provider Name | Derek Means |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740771013 PECOS PAC ID: 5294082467 Enrollment ID: I20210825002957 |
| Provider Name | Kelli A Dobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184218604 PECOS PAC ID: 5597163048 Enrollment ID: I20211013002548 |
| Provider Name | Ngozi Bridget Agorua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316515554 PECOS PAC ID: 0446641229 Enrollment ID: I20220105002213 |
| Provider Name | Tuan Anh Pham |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1447785670 PECOS PAC ID: 6305238452 Enrollment ID: I20220121001476 |
| Provider Name | Kelsey Leigh Brittingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003414145 PECOS PAC ID: 4183017965 Enrollment ID: I20220201000624 |
| Provider Name | Karen Aliene Sturgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831859776 PECOS PAC ID: 5193110443 Enrollment ID: I20220323000973 |
| Provider Name | Ramon Antonio Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760008304 PECOS PAC ID: 2466830336 Enrollment ID: I20220606000307 |
| Provider Name | Esther Ewele Etumudor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598312159 PECOS PAC ID: 0648651307 Enrollment ID: I20220713001497 |
| Provider Name | Andrea Nicole Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285226340 PECOS PAC ID: 9638551880 Enrollment ID: I20220803004051 |
| Provider Name | Alexander James Demand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609337757 PECOS PAC ID: 3577947555 Enrollment ID: I20220825002710 |
| Provider Name | Mitchell Ryan Hudgens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891429163 PECOS PAC ID: 7517372774 Enrollment ID: I20220910000564 |
| Provider Name | Martha Claire Kelly-legler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588241749 PECOS PAC ID: 1153786231 Enrollment ID: I20230424002961 |
| Provider Name | Chelsea Jordan Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124725577 PECOS PAC ID: 0749646966 Enrollment ID: I20230515000132 |
| Provider Name | Dawn Annette Buffington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003532300 PECOS PAC ID: 0345604948 Enrollment ID: I20230915000582 |
| Provider Name | Victoria Delaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467133439 PECOS PAC ID: 4587012869 Enrollment ID: I20231127003083 |
| Provider Name | John C Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184881047 PECOS PAC ID: 6406206119 Enrollment ID: I20231221000672 |
| Provider Name | Irene Bjorg Warwick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295971729 PECOS PAC ID: 4688025612 Enrollment ID: I20240104000098 |
| Provider Name | Dakota Shane Sixkiller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659072775 PECOS PAC ID: 6204279557 Enrollment ID: I20240204000064 |
| Provider Name | Eniola Aina Osifeso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831779040 PECOS PAC ID: 8123461480 Enrollment ID: I20240205000304 |
| Provider Name | Remy Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275071722 PECOS PAC ID: 6103269378 Enrollment ID: I20240206000071 |
| Provider Name | Steve Calico |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124161245 PECOS PAC ID: 7416390208 Enrollment ID: I20240208002689 |
| Provider Name | Derrick Adrian Braddick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942456959 PECOS PAC ID: 7810332715 Enrollment ID: I20240301001672 |
Tulsa Internal Medicine Physicians, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 S Wheeling Ave, Ste 1000, Tulsa, OK 74104 Phone: 918-748-8467 | |
Family Health And Wellness Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 Phone: 918-740-4630 Fax: 918-289-0091 | |
Family Medical Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4134 S Harvard Ave Ste B3, Tulsa, OK 74135 Phone: 918-442-2236 Fax: 918-794-2333 | |
Community Health Connection, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13702 E 46th Pl, Tulsa, OK 74134 Phone: 918-622-0641 Fax: 918-622-4814 | |
Qt Quikmed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4705 S 129th East Ave, Tulsa, OK 74134 Phone: 918-994-3953 | |
Sunshine Care Partners Of Dfw Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1532 S Peoria Ave, Tulsa, OK 74120 Phone: 918-609-5600 | |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 N 161st East Ave, Tulsa, OK 74116 Phone: 800-993-8244 |