OSU CENTER FOR HEALTH SCIENCES (NPI# 1083049001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083049001 |
| Entity Type | Organization |
| Organization Name | OSU CENTER FOR HEALTH SCIENCES |
| Other Organization Name | OSU-AJ INTEGRIS GRAND LAKE ENT |
| Practice Address |
900 E 13th St Suite 201 Grove OK 74344-2976 |
| Mailing Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Practice Telephone | 9185618306 |
| Practice Fax Number | 9185615747 |
| Mailing Telephone | 9185618306 |
| Mailing Fax Number | 9185615747 |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2016-08-20 |
| Authorized Official Name | ERIC POLAK (CFO OSU PHYSICIANS) |
| Authorized Official Telephone | 9185618422 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| OSU-AJ INTEGRIS GRAND LAKE ENT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| 1447895586 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste 201, Lawton, OK 73505-6350 | 2019-11-13 |
| 1952957995 | Osu Center for Health Sciences | Clinic/Center | 10507 E 91st St Ste 550, Tulsa, OK 74133-5590 | 2019-08-15 |
| 1942852694 | Osu Center for Health Sciences | Clinic/Center | 1201 W 6th Ave, Stillwater, OK 74074-4307 | 2019-07-12 |
| 1538639190 | Osu Center for Health Sciences | Clinic/Center | 6465 S. Yale Ave. Suite 514, Tulsa, OK 74136 | 2018-11-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OSU CENTER FOR HEALTH SCIENCES | 1111 W 17th St, Tulsa, OK 74107-1886 |
| Street Address |
900 E 13TH ST SUITE 201 |
| City | GROVE |
| State | OK |
| Zip Code | 74344-2976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411536 | Paul Edward Callicoat Jr. | Internal Medicine | 900 E 13th St, Suite 200, Grove, OK 74344-2975 | 2005-07-18 |
| 1639511157 | Tessa Lynn Longan | Nurse Practitioner | 900 E 13th St, Suite 205, Grove, OK 74344-2975 | 2013-07-25 |
| 1326304643 | Ashley Shelley | Obstetrics & Gynecology | 900 E 13th St, Suite 205, Grove, OK 74344-2975 | 2012-04-11 |
| 1447551817 | Kelly Patricia Long | Nurse Practitioner | 900 E 13th St, Suite 101, Grove, OK 74344-2975 | 2010-11-16 |
| 1598904526 | Kioumars (none) Zarintash | Family Medicine | 900 E 13th St, 104, Grove, OK 74344-2975 | 2009-02-15 |
| 1851555239 | Tyson Richard Trimble | Orthopaedic Surgery | 900 E 13th St, Suite 104, Grove, OK 74344-2975 | 2008-07-15 |
| 1316092182 | Renee J Russell Md Inc | Family Medicine | 900 E 13th St, Suite 104, Grove, OK 74344-2975 | 2007-01-24 |
| 1619041720 | Osu Center for Health Sciences | Clinic/Center | 900 E 13th St, Suite 201, Grove, OK 74344-2975 | 2006-11-20 |
| 1124030002 | James B Chapman | Internal Medicine | 900 E 13th St, Suite 200, Grove, OK 74344-2975 | 2006-08-12 |
| 1326067174 | Douglas Allen Ohlstrom | Surgery | 900 E 13th St, Suite 102, Grove, OK 74344-2975 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604935 | Deborah Stauss | Massage Therapist | 2086 S Main St, Grove, OK 74344 | 2019-05-20 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1205329232 | Andra Renee Mitchell | Speech-Language Pathologist | 825 E Third Street, Grove, OK 74344 | 2018-06-13 |
| 1861996217 | Jenniffer Colleen Clark I | Case Manager/Care Coordinator | 1115 Har-ber Rd, Grove, OK 74344 | 2018-03-21 |
| 1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
| 1659872034 | Keli Elaine Whitlock | Peer Specialist | 5602 Us Hwy 59, Grove, OK 74344 | 2018-02-22 |
| 1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
| 1043766645 | Samantha Lane | Speech-Language Pathologist | 1046 Hillside Road, Grove, OK 74344 | 2016-09-01 |
| 1376927509 | Matthew Kyle Allen | Physical Therapy Assistant | 4621 Hwy 59 N, Grove, OK 74344 | 2015-07-17 |
| 1477807428 | Andrew Scott Littlejohn | Physical Therapy Assistant | 103 Harber Road, Grove, OK 74344 | 2012-10-30 |
| Find all providers in zip 74344 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134456551 | Lesa Landon and Amber Landon | Clinic/Center | 63153 East 290 Road, Grove, OK 74344 | 2009-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1235757071 | Equality Health Group LLC | Clinic/Center | 4301 Nw 63rd St Ste 109, Oklahoma City, OK 73116-1548 | 2020-07-08 |
| 1538785985 | Stars and Stripes Therapy Inc. | Clinic/Center | 713 Sw C Ave Ste A, Lawton, OK 73501-4311 | 2020-06-22 |
| 1265058101 | Taylor Medical Group, LLP | Clinic/Center | 735 W Locust St, Stilwell, OK 74960-3403 | 2020-06-16 |
| 1891317731 | Sparks Medical Consulting LLC | Clinic/Center | 1604 Sw 38th St, Moore, OK 73160-2953 | 2020-05-14 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
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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.