DR. NICKEY GLENN KNUTSON (NPI# 1558328559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558328559 |
| Entity Type | Individual |
| Full Name | DR. NICKEY GLENN KNUTSON |
| Credential | M.D. |
| Practice Address |
8100 S Walker Ave Bldg A, Suite 230 Oklahoma City OK 73139-9402 |
| Practice Telephone | 4056310481 |
| Practice Fax Number | 4056319025 |
| Mailing Telephone | 4056310481 |
| Mailing Fax Number | 4056319025 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
10530 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BLUE CROSS/BLUE SHIELD | 731135951001 | 01 |
| Street Address |
8100 S WALKER AVE BLDG A, SUITE 230 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73139-9402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139692 | Anthony Cruse | Orthopaedic Surgery | 8100 S Walker Ave, Bldg A, Oklahoma City, OK 73139-9402 | 2005-07-28 |
| 1174997753 | Anesthesia Partners of Oklahoma, LLC | Anesthesiology | 8100 S Walker Ave, Bldg C, Oklahoma City, OK 73139-9402 | 2015-11-19 |
| 1992174304 | Uap of Oklahoma, Inc. | Nurse Anesthetist, Certified Registered | 8100 S Walker Ave, Bldg C, Oklahoma City, OK 73139-9402 | 2015-09-16 |
| 1366862245 | Somnium Dme LLC | Durable Medical Equipment & Medical Supplies | 8100 S Walker Ave, Building C, Oklahoma City, OK 73139-9402 | 2014-04-18 |
| 1568793412 | Osu Center for Health Sciences | Clinic/Center | 8100 S Walker Ave, Bldg A, Oklahoma City, OK 73139-9402 | 2010-01-15 |
| 1205017530 | Donna A. Johnson, Md, Pllc | Pediatrics | 8100 S Walker Ave, Ste 200, Oklahoma City, OK 73139-9402 | 2007-11-15 |
| 1194934646 | Jessica L Brooks | Specialist/Technologist | 8100 S Walker Ave, Suite B, Oklahoma City, OK 73139-9402 | 2007-05-22 |
| 1740400274 | Nick Knutson Md, A Professional Corporation | Internal Medicine | 8100 S Walker Ave, Building A, Suite 230, Oklahoma City, OK 73139-9402 | 2007-04-26 |
| 1669559720 | Southwest Orthopaedic Specialists, P.l.l.c. | Orthopaedic Surgery | 8100 S Walker Ave, Building A, Oklahoma City, OK 73139-9404 | 2006-11-01 |
| 1952486292 | Daniel Lee Md | Internal Medicine | 8100 S Walker Ave, Bldg C, Oklahoma City, OK 73139-9402 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899778 | First Med Primary Care LLC | Clinic/Center | 1142 Sw 104th St, Oklahoma City, OK 73139 | 2020-01-03 |
| 1205305737 | Transit Medical Team LLC | In Home Supportive Care | 1145 S I-240 Service Rd Ste F, Oklahoma City, OK 73139 | 2018-11-14 |
| 1336621770 | Mayra Edith Solis | Case Manager/Care Coordinator | 6510 S. Western Ave Bldg. 400, Oklahoma City, OK 73139 | 2018-09-01 |
| 1619470184 | Linzi L Stewart, D.o., P.l.l.c. | Obstetrics & Gynecology | 10400 S Western Ave Ste 7, Oklahoma City, OK 73139 | 2018-03-12 |
| 1467970467 | Oklahoma Healthcare Transitions Inc | Home Health | 6803 S Western Ave Ste 400, Oklahoma City, OK 73139 | 2017-08-30 |
| 1841714169 | Gentry Kyler Jones | Case Manager/Care Coordinator | 301 W I240 Service Rd, Oklahoma City, OK 73139 | 2017-07-28 |
| 1437688082 | Jasmine Small | Case Manager/Care Coordinator | 6100 S Walker, Okc, OK 73139 | 2017-06-07 |
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1225491343 | Elizabeth Pratt | Counselor | 301 Interstate 240 Service Rd, Oklahoma City, OK 73139 | 2016-04-05 |
| 1326418542 | Brittany Elis Walley | Case Manager/Care Coordinator | 8015 S Klein Ave, Oklahoma City, OK 73139 | 2015-09-30 |
| Find all providers in zip 73139 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568706554 | Ahmad S Jazzar | Internal Medicine | 5617 Normandy Ter, Oklahoma City, OK 73142-1823 | 2012-11-15 |
| 1730444886 | Molly Beth Lindquist Disbrow | Internal Medicine | 920 Stanton L Young Blvd # Wp1345, Oklahoma City, OK 73104-5036 | 2012-07-05 |
| 1306111448 | Southwest Gastroenterology Associates Pllc | Internal Medicine | 525 Sw 80th Street, Suite 200, Oklahoma City, OK 73139 | 2012-03-21 |
| 1528199866 | Verapan Vongthavaravat | Internal Medicine | 4811 Gaillardia Pkwy Ste 200, Oklahoma City, OK 73142-1874 | 2007-03-08 |
| 1992852875 | Shih-kuang Hong | Internal Medicine | 3110 Sw 89th St Ste 104, Oklahoma City, OK 73159-7920 | 2007-01-04 |
| 1083709430 | Imad A Zantout | Internal Medicine | 4200 W.memorial Road, Suite 305, Oklahoma City, OK 73120 | 2006-10-03 |
| 1659308435 | Rajesh Kanagala | Internal Medicine | 825 Ne 10th St # Street4e, Oklahoma City, OK 73104-5417 | 2006-06-27 |
| 1649245929 | Jeff D Scott | Internal Medicine | 5015 N Pennsylvania Ave, Suite 303, Oklahoma City, OK 73112-8891 | 2006-02-21 |
| 1285606491 | Sophia Janjua Khan | Internal Medicine | 4205 Mcauley Blvd Ste 375, Oklahoma City, OK 73120 | 2006-02-02 |
| 1639153554 | Ross Stanford Keener | Internal Medicine | 4201 S Western Ave, Oklahoma City, OK 73109-3410 | 2005-12-05 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73139 |
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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.