NORTHERN OKLAHOMA REGIONAL PEDIATRIC CLINIC, PLLC


Address: 415 Fairview Ave, Ste. 100, Ponca City, OK 74601-1923
Phone: 5807655569

NORTHERN OKLAHOMA REGIONAL PEDIATRIC CLINIC, PLLC (NPI# 1053486431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053486431
Entity Type Organization
Organization Name NORTHERN OKLAHOMA REGIONAL PEDIATRIC CLINIC, PLLC
Practice Address 415 Fairview Ave
Ste. 100
Ponca City
OK 74601-1923
Practice Telephone 5807655569
Practice Fax Number 5807652020
Mailing Telephone 5807655569
Mailing Fax Number 5807652020
Enumeration Date 2006-11-21
Last Update Date 2017-05-12
Authorized Official Name MS. CHRIS W POLLAK (ADMINISTRATOR)
Authorized Official Telephone 5807655569
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080A0000X Pediatrics
Specialization: Adolescent Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OK 100749170C 05

Office Location

Street Address 415 FAIRVIEW AVE
STE. 100
City PONCA CITY
State OK
Zip Code 74601-1923

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700839099 David Michael Sparks Orthopaedic Surgery 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1923 2006-05-18
1841671906 Lacey Mcnett Nurse Practitioner 415 Fairview Ave, St 100, Ponca City, OK 74601-1929 2015-06-15
1710206313 Candy Lee Sconyers Lindsey Family Medicine 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1929 2010-05-20
1962504746 Dr. David M. Sparks, M.d., Pllc Specialist 415 Fairview Ave, Suite 201, Ponca City, OK 74601-1923 2006-09-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245867258 Triad Health Systems LLC Family Medicine 2703 N 14th St, Ponca City, OK 74601 2020-03-27
1679096952 Gabrielle Evangeline Barnes Case Manager/Care Coordinator 620 W. Grand, Ponca City, OK 74601 2017-07-19
1942722889 Kimbra Leigh Anderson Case Manager/Care Coordinator 1500 N. 6th, Ponca City, OK 74601 2017-07-12
1033631965 Kayla Patten Case Manager/Care Coordinator 620 W Grand, Ponca, OK 74601 2017-07-12
1639601859 Affordable Dental Dentist 1618 N 5th St Ste 4, Ponca City, OK 74601 2017-03-28
1447627237 Harold Jason Laughlin Jr. Chiropractor 222 E. Grand, Ste. 309, Ponca City, OK 74601 2015-08-27
1578947875 Jessica James Social Worker 1500 N 6th, Ponca City, OK 74601 2015-07-16
1639565153 Ryian Reyes Point of Service 2101 N 14th, Suite 134, Ponca City, OK 74601 2015-04-10
1003253006 Proving Faithful Investments Inc. Home Health 205 W. Hartford Avenue #112, Ponca City, OK 74601 2013-05-30
1427365899 Quint Allen Whitefield Dentist 1618 N. 5th Street, Suite #2, Ponca City, OK 74601 2010-09-08
Find all providers in zip 74601

Taxonomy Information

Taxonomy Code 2080A0000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Adolescent Medicine

Taxonomy Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356544951 Kristin Diane Conkling Pediatrics 5125 E 107th Pl, Tulsa, OK 74137-7236 2007-06-09
1780789362 Children & Adolescent Medical Services Inc. Pediatrics 8803 S. 101st E. Ave., Suite 200, Tulsa, OK 74133 2006-09-14
1770504037 Miguel Antonio Camacho-garrido Pediatrics 1104 Walnut Dr, Ardmore, OK 73401-2353 2006-07-22
1497788624 Shelley Ann Bohn Pediatrics 937 Sw 89th St, Suite A, Oklahoma City, OK 73139-9231 2006-07-09
1922038348 Paul Andrew Scott Benson Pediatrics 4444 E. 41st Street, 2nd Floor, Ou Physicians -- Pediatrics, Tulsa, OK 74135 2006-07-03
1235128430 Elizabeth Gail Lewis Pediatrics 2701 Sw Cornell Ave, Lawton, OK 73505-7121 2005-10-19
1871581470 Charles R Mettry Pediatrics 201 N Monte Vista St, Suite B, Ada, OK 74820-7200 2005-10-10
1578568010 Julie Gail Sullivan Pediatrics 1615 S Eucalyptus Ave, Suite 210, Broken Arrow, OK 74012-6159 2005-06-20
1902446917 Chelsea Ryan Walker Pediatrics 12455 E 100th St N Ste 300, Owasso, OK 74055-4678 2020-01-08
1609005842 Ahmad Pediatrics Pediatrics 302 E Downing St, Tahlequah, OK 74464-3014 2009-07-09
Find all providers with the same taxonomy

Competitor

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City PONCA CITY
Zip Code 74601

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Dataset Information

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.

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