OKLAHOMA MEDICAL CLINIC LLC (NPI# 1629489612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629489612 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA MEDICAL CLINIC LLC |
| Practice Address |
10317 Greenbriar Pkwy Oklahoma City OK 73159-7648 |
| Practice Telephone | 4053783400 |
| Practice Fax Number | 1866323795 |
| Mailing Telephone | 4053783400 |
| Mailing Fax Number | 8663237959 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-04-23 |
| Authorized Official Name | DR. TRACY ELLIS (MEMBER) |
| Authorized Official Telephone | 4056647622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE DME | 7663770001 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | OKLAHOMA MEDICAL CLINIC LLC | 3334 W Main #454, Norman, OK 73072 |
| Street Address |
10317 GREENBRIAR PKWY |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73159-7648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174552947 | Ct Associates No. 1, L.L.C. | Clinic/Center | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2006-07-02 |
| 1689950180 | Diagnostic Imaging Solutions | Clinic/Center | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2011-10-27 |
| 1588940084 | Comps Medical | Clinic/Center | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2011-10-27 |
| 1093037046 | 415 Main LLC | Chiropractor | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2010-02-18 |
| 1679895700 | Tracy Ellis | Chiropractor | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2010-02-16 |
| 1699903922 | Central Diagnostics | Clinic/Center | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2009-06-25 |
| 1720216054 | Eastern Diagnostics | Clinic/Center | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2009-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346849528 | Mel Vision LLC | Optometrist | 1413 W Interstate 240 Service Rd, Suite E, Oklahoma City, OK 73159 | 2020-10-20 |
| 1053959247 | Phillip J Elassal Dds Pllc | Clinic/Center | 1601 Sw 89th Street #g500, Oklahoma City, OK 73159 | 2019-12-18 |
| 1629573407 | Carrie Lynn Sanchez | Case Manager/Care Coordinator | 2604 Sw 92nd Street, Oklahoma City, OK 73159 | 2018-03-26 |
| 1407368038 | Deborah Dorton | Psychologist | Okc Va Hcs (111a), 921 Ne 13th St, Oklahoma City, OK 73159 | 2017-11-06 |
| 1366969933 | Matthew Lewis Hearne | Case Manager/Care Coordinator | 7504 S Country Club Dr, Apt 105, Oklahoma City, OK 73159 | 2017-08-24 |
| 1043766405 | Pro Hearing, LLC | Clinic/Center | 10404 S Pennsylvania Ave, Oklahoma City, OK 73159 | 2016-08-26 |
| 1952764169 | Doc LLC | Orthopaedic Surgery | 3130 Sw 89th St Ste 200e, Oklahoma City, OK 73159 | 2016-04-04 |
| 1235511288 | Anusha Koneru | Dentist | 1610 W Interstate 240 Service Road, Oklahoma City, OK 73159 | 2015-06-26 |
| 1114347069 | Crystal A Dockery | Family Medicine | 3212 Sw 89th St Ste 100, Oklahoma City, OK 73159 | 2014-04-18 |
| 1790121440 | Kimberly Anne Dyer | Occupational Therapy Assistant | 5725 S Ross, Oklahoma City, OK 73159 | 2013-05-21 |
| Find all providers in zip 73159 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437774874 | Saints Medical Group, LLC | Physical Medicine & Rehabilitation | 3400 S Douglas Blvd Ste 306, Oklahoma City, OK 73150-1001 | 2020-06-11 |
| 1184182297 | Dynamic Rehab Inc | Physical Medicine & Rehabilitation | 7825 S Walker Ave Ste C, Oklahoma City, OK 73139-9410 | 2019-03-07 |
| 1295221422 | Flexogenix Oklahoma, PC | Physical Medicine & Rehabilitation | 9300 N Kelley Ave, Oklahoma City, OK 73131-2427 | 2018-07-11 |
| 1134658024 | The Deweber Group, LLC | Physical Medicine & Rehabilitation | 8800 S Pennsylvania Ave Ste 101, Oklahoma City, OK 73159-5211 | 2017-06-05 |
| 1851764708 | Oklahoma Sports & Spine Medicine,pllc | Physical Medicine & Rehabilitation | 121 Ne 50th St, Oklahoma City, OK 73105-1809 | 2015-10-31 |
| 1962702563 | Kristi Self, M.d., P.C. | Physical Medicine & Rehabilitation | 5100 N Brookline Ave Ste 500, Oklahoma City, OK 73112-3626 | 2010-10-28 |
| 1790714590 | Albert Joseph Bisson | Physical Medicine & Rehabilitation | 4120 W Memorial Rd Ste 118, Oklahoma City, OK 73120-9322 | 2006-07-02 |
| 1265471379 | James K Lee | Physical Medicine & Rehabilitation | 4802 Nw 10th St, Occuhealth Associates, Oklahoma City, OK 73127-5816 | 2006-06-05 |
| 1972551893 | American Intraoperative Monitoring LLC | Physical Medicine & Rehabilitation | 13401 Railway Dr, Oklahoma City, OK 73114-2272 | 2006-05-04 |
| 1265490460 | David Brent Tipton | Physical Medicine & Rehabilitation | 4219 S Western Ave, Oklahoma City, OK 73109-3410 | 2006-05-04 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73159 |
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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.