AMATTCO LLC (NPI# 1477009256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477009256 |
| Entity Type | Organization |
| Organization Name | AMATTCO LLC |
| Other Organization Name | NEW LEAF WELLNESS CENTER |
| Practice Address |
3100 S Elm Pl Suite B Broken Arrow OK 74012-7950 |
| Mailing Address |
3705 West Memorial Rd Suite 601 Oklahoma City OK 73134-1512 |
| Practice Telephone | 9188847800 |
| Practice Fax Number | 9187314518 |
| Mailing Telephone | 4057519800 |
| Mailing Fax Number | 4057519808 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |
| Authorized Official Name | DR. DAVID RYKER SR. (SUPERVISING PHYSICAN) |
| Authorized Official Telephone | 4057519800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | AMATTCO LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 9365 | OK | Other Service Providers |
| N | 363L00000X | Nurse Practitioner | 79139 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | R0078723 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 86262 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 174400000X | Specialist | 73548 | OK | Other Service Providers |
| Other Name | Type Code |
|---|---|
| New Leaf Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023354842 | Amattco LLC | Clinic/Center | 3705 West Memorial Rd Suite 601, Oklahoma City, OK 73134 | 2012-12-26 |
| Street Address |
3100 S ELM PL SUITE B |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-7950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839446 | Leroy O. Jeske | Family Medicine | 3100 S Elm Pl, Ste A, Broken Arrow, OK 74012-7950 | 2005-05-23 |
| 1497120901 | Jo-anna Coppin Lohr | Nurse Practitioner | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012 | 2015-12-09 |
| 1437453537 | Allison Sawyer | Counselor | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2011-01-04 |
| 1467754218 | Paige E Oberhammer | Counselor | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2010-11-30 |
| 1306156740 | Kendra Julie Denee Lemons | Counselor | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2010-10-19 |
| 1710206834 | Kenya Turner | Counselor | 3100 S Elm Pl, Ste B, Broken Arrow, OK 74012-7950 | 2010-05-28 |
| 1891017463 | Ruby Christine Morain | Behavioral Analyst | 3100 S Elm Pl, Broken Arrow, OK 74012-7950 | 2010-02-23 |
| 1770811879 | Paige Tallent | Counselor | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2009-12-01 |
| 1316275803 | Rebekah L Ammerman-clarke | Counselor | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2009-11-23 |
| 1215183801 | Health Network, LLC | Community/Behavioral Health | 3100 S Elm Pl, Suite B, Broken Arrow, OK 74012-7950 | 2008-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457749160 | Rhonda Herron | Specialist | 19305 E 46th St S, Broken Arrow, OK 74014-1367 | 2015-01-05 |
| 1265696223 | Kathleen Ann Adams | Specialist | 7303 S Oak Pl, Broken Arrow, OK 74011-5804 | 2008-07-17 |
| 1245491448 | Kerstin Inger West-wilson | Specialist | 2409 W Twin Oaks St, Broken Arrow, OK 74011-1453 | 2008-06-19 |
| 1740465376 | Penny Kumrow | Specialist | 2212 W Nashville St, Broken Arrow, OK 74012-4723 | 2008-01-02 |
| 1770615312 | Paul Yosepa Lewis | Specialist | 1605a S Main St, Broken Arrow, OK 74012-5604 | 2007-03-09 |
| 1164450342 | Karla Moseley | Specialist | 2208 N Yellowood Ave, Broken Arrow, OK 74012-9102 | 2006-06-28 |
| 1003851114 | Andrea Pearl Humphreys | Specialist | 3213 N 8th Pl, Broken Arrow, OK 74012-8221 | 2006-06-20 |
| 1780972224 | Tulsa Urology Plc | Specialist | 800 W Boise Cir, #210, Broken Arrow, OK 74012-4906 | 2011-07-19 |
| 1417251547 | Autism Behavior Consultants of Oklahoma, Ltd | Specialist | 2208 N Yellowood Ave, Broken Arrow, OK 74012-9102 | 2011-01-04 |
| 1033443601 | Douglas Mitchell | Specialist | 2208 N Yellowood Ave, Broken Arrow, OK 74012-9102 | 2009-09-29 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.