MIRAWORX OF OKC 1 LLC


Address: 10400 Vineyard Blvd Apt A, Oklahoma City, OK 73120-3830
Phone: 4052301102

MIRAWORX OF OKC 1 LLC (NPI# 1053641803) 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) 1053641803
Entity Type Organization
Organization Name MIRAWORX OF OKC 1 LLC
Practice Address 10400 Vineyard Blvd Apt A
Oklahoma City
OK 73120-3830
Practice Telephone 4052301102
Mailing Telephone 4052301102
Enumeration Date 2009-12-29
Last Update Date 2009-12-29
Authorized Official Name MRS. CAROLYN CUMMINS DAVIES (CONSULTANT)
Authorized Official Telephone 9182867347
Authorized Official Credential CPA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 10400 VINEYARD BLVD APT A
City OKLAHOMA CITY
State OK
Zip Code 73120-3830

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134768971 Nuvail Medical Services Inc In Home Supportive Care 3140 West Britton Road, Suite A, Oklahoma City, OK 73120 2019-12-26
1134781677 Peak Solutions, LLC Clinic/Center 12401 Trail Oaks Drive, Therapy Room, 2nd Floor, Oklahoma City, OK 73120 2019-07-05
1992363881 Laura Lynn's Home Care, LLC Home Health 9801 N May Ave, Oklahoma City, OK 73120 2019-06-05
1962992115 Erin Lyn Florer Occupational Therapist 12401 Trail Oak Dr, Oklahoma City, OK 73120 2018-05-14
1780171009 Diabetic Foot and Wound Center of Okfas Podiatrist 11100 Hefner Pointe Drive, Suite A, Oklahoma City, OK 73120 2018-04-23
1285134387 Motley Vision Professionals, Pllc Eyewear Supplier (Equipment, not the service) 9805 N. May Avenue, Oklahoma City, OK 73120 2018-02-15
1043729700 Jenna Marie Howard Social Worker 3301 North Meridian Ave., Building 100, Oklahoma City, OK 73120 2017-09-26
1962928895 Susan Chacko Counselor 12000 N Virginia Avenue, Oklahoma City, OK 73120 2017-08-22
1023533262 Farris Ree Stroupe Audiologist 4140 W. Memorial Rd Suite 116, Oklahoma City, OK 73120 2017-08-09
1881116200 Rebekah Danielle Kabariti Counselor 12000 N. Virgnia Ave, Oklahoma City, OK 73120 2017-07-07
Find all providers in zip 73120

Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467495226 Kelly Medical, PC Family Medicine 13921 N Meridian Ave Ste 100, Oklahoma City, OK 73134-1106 2006-06-13
1184269706 Consulting Medical, Pllc Family Medicine 13654 S Western Ave, Oklahoma City, OK 73170-7004 2019-11-07
1972851467 Ingram Co Family Medicine 6525 N Meridian Ave, Oklahoma City, OK 73116-1420 2012-08-15
1801032297 Lynn Dean Baggett Family Medicine 3033 N Walnut Ave, Oklahoma City, OK 73105-2832 2009-01-06
1497971733 Paul Davis Johnson Family Medicine 7100 S I 35 Service Rd, Suite # 7, Oklahoma City, OK 73149-2740 2007-04-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1962031369 Prompt Care Clinic LLC Family Medicine 4008 Nw Cache Rd, Lawton, OK 73505-3634 2020-04-07
1982141362 Allison Eldridge Family Medicine 7477 E 46th Pl, Tulsa, OK 74145-6305 2017-01-24
1649715608 Vizown, LLC Family Medicine 24962 Okay Rd, Tecumseh, OK 74873-6504 2016-12-30

Competitor

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City OKLAHOMA CITY
Zip Code 73120

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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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