TRACEY WAY CHILDERS (NPI# 1053371021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053371021 |
| Entity Type | Individual |
| Full Name | TRACEY WAY CHILDERS |
| Credential | D.O. |
| Practice Address |
1203 E Ross Byp Suite A Tahlequah OK 74464-4188 |
| Practice Telephone | 9184531234 |
| Practice Fax Number | 9184539107 |
| Mailing Telephone | 9184531234 |
| Mailing Fax Number | 9184539107 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2011-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
3296 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100257460A | 05 | |
| OK | 200000030A | 05 | |
| OK | RAILROAD MEDICARE PIN NUMBER | P00027981 | 01 |
| OK | RAILROAD MEDICARE GROUP NUMBER | DA5295 | 01 |
| Street Address |
1203 E ROSS BYP SUITE A |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-4188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700875598 | Lori Lyn Enlow | Nurse Practitioner | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 | 2005-10-14 |
| 1073164125 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2019-09-20 |
| 1023311438 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 | 2010-12-08 |
| 1649584855 | Lea Sarah Humphrey | Otolaryngology | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-29 |
| 1316258619 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-01 |
| 1659568301 | Cmg Family Clinic LLC | Family Medicine | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-09-26 |
| 1720274699 | Tracey W. Childers, D.o. P.C. | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2007-09-24 |
| 1730227299 | Philip Dean Watson | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-02-04 |
| 1568412310 | Susan K Anderson | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2006-05-11 |
| 1114909843 | Andrea D Mitchell | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2005-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649584855 | Lea Sarah Humphrey | Otolaryngology | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538674783 | Timothy Jones Md Pllc | Otolaryngology | 13150 N Macarthur Blvd, Oklahoma City, OK 73142-3017 | 2017-12-11 |
| 1023493566 | Chase K Nelson | Otolaryngology | 744 W 9th St, Tulsa, OK 74127-9020 | 2015-07-27 |
| 1396123246 | Caleb Eugene Burrows | Otolaryngology | 2000 S Wheeling Ave, Ste 900, Tulsa, OK 74104-5647 | 2015-05-12 |
| 1275822926 | Bryan Terry Smedley | Otolaryngology | 10512 N 110th East Ave, Suite 210, Owasso, OK 74055-6636 | 2011-04-04 |
| 1770885931 | Ent Associates Pllc | Otolaryngology | 1201 S Douglas Blvd, Ste L, Midwest City, OK 73130-5239 | 2010-11-21 |
| 1831352723 | Jean-maria Christina Langley | Otolaryngology | 9001 S 101st East Ave, Suite 280, Tulsa, OK 74133-5708 | 2008-07-09 |
| 1427003854 | Troy E Major IIi | Otolaryngology | 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 | 2006-05-24 |
| 1528021912 | Paul David Hunter | Otolaryngology | 535 Nw 9th St, Suite 300, Oklahoma City, OK 73102-1070 | 2006-04-08 |
Please comment or provide details below to improve the information on TRACEY WAY CHILDERS.
| 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.