HOMETOWN NEURODIAGNOSTICS-COLORADO LLC (NPI# 1265803829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265803829 |
| Entity Type | Organization |
| Organization Name | HOMETOWN NEURODIAGNOSTICS-COLORADO LLC |
| Practice Address |
11900 N Macarthur Blvd Ste E2 Oklahoma City OK 73162-1859 |
| Mailing Address |
200 Union Blvd Ste. 200 Lakewood CO 80228-1830 |
| Practice Telephone | 4052861016 |
| Practice Fax Number | 4052422016 |
| Mailing Telephone | 4052861016 |
| Mailing Fax Number | 4052422016 |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | TONYA L JACK (ADMINISTRATOR) |
| Authorized Official Telephone | 4052861016 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Hometown Neurodiagnostics-Colorado LLC | 200 Union Blvd, Ste. 200, Lakewood, CO 80228 |
| Street Address |
11900 N MACARTHUR BLVD STE E2 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73162-1859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255736724 | Hometown Neurodiagnostics, LLC. | Specialist/Technologist, Other | 11900 N Macarthur Blvd Ste E2, Oklahoma City, OK 73162-1859 | 2014-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114493319 | Anthony Haislip | Peer Specialist | 6904 Briar Creek Dr., Oklahoma City, OK 73162 | 2018-10-16 |
| 1760973705 | Lars Pederson | Peer Specialist | 7308 Nw 114th St, Oklahoma City, OK 73162 | 2018-05-25 |
| 1770026841 | Cory Chambers | Dentist | 12321 N. Council Rd, Oklahoma City, OK 73162 | 2016-11-22 |
| 1487109062 | K. Williams | Case Manager/Care Coordinator | 10400 North Council Road, Oklahoma City, OK 73162 | 2016-08-24 |
| 1932537669 | Al Dowell | Case Manager/Care Coordinator | 8849 Nw 121st St., Oklahoma City, OK 73162 | 2013-10-15 |
| 1508106378 | Wilvia Wong-plum | Counselor | 7309 N.w. 107th St., Oklahoma City, OK 73162 | 2013-02-15 |
| 1386912301 | Delores Parker | Counselor | 11916 Silvermoon Drive, Oklahoma City, OK 73162 | 2011-12-05 |
| 1518241744 | Victor Njoh | Pharmacist | 7101 West Hefner Rd, Oklahoma City, OK 73162 | 2011-10-06 |
| 1841500113 | Kimmi Jo Stanley | Speech-Language Pathologist | 9400 St. Ann's Home, Oklahoma City, OK 73162 | 2010-10-20 |
| 1548493091 | Glen Knight Wallace | Counselor | 7932 Nicholson, Okalhoma City, OK 73162 | 2009-09-01 |
| Find all providers in zip 73162 | ||||
| Taxonomy Code | 246ZE0500X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | EEG |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
| 1255736724 | Hometown Neurodiagnostics, LLC. | Specialist/Technologist, Other | 11900 N Macarthur Blvd Ste E2, Oklahoma City, OK 73162-1859 | 2014-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760620827 | Numan LLC | Specialist/Technologist, Other | 7225 S 85th East Ave, Suite 200, Tulsa, OK 74133-3157 | 2009-01-28 |
| 1013178565 | North Texas Neuroprotekt, Pa | Specialist/Technologist, Other | 9521 B Riverside Parkway #338, Tulsa, OK 74137-7422 | 2008-06-18 |
| 1003834474 | Neuro Links, Inc | Specialist/Technologist, Other | 1145 S Utica Ave Ste 901, Tulsa, OK 74104-4005 | 2006-07-17 |
| 1285872887 | Janna T Cheek | Specialist/Technologist, Other | 1145 S Utica Ave, Suite 901, Tulsa, OK 74104-4000 | 2009-02-04 |
| City | OKLAHOMA CITY |
| Zip Code | 73162 |
Please comment or provide details below to improve the information on HOMETOWN NEURODIAGNOSTICS-COLORADO LLC.
| 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.