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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 100749170C | 05 |
Street Address |
415 FAIRVIEW AVE STE. 100 |
City | PONCA CITY |
State | OK |
Zip Code | 74601-1923 |
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 |
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 Code | 2080A0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Adolescent Medicine |
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. |
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 |
City | PONCA CITY |
Zip Code | 74601 |
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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.