PEDISTAT, PLLC (NPI# 1639515471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639515471 |
| Entity Type | Organization |
| Organization Name | PEDISTAT, PLLC |
| Other Organization Name | PEDISTAT |
| Practice Address |
3354 E 51st St Tulsa OK 74135-3512 |
| Practice Telephone | 9188531634 |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |
| Authorized Official Name | DR. ETHAN AAEON WARLICK (PRESIDENT) |
| Authorized Official Telephone | 9188531634 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
21053 | OK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PediStat | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | PEDISTAT, PLLC | 1123 E 20th St., Tulsa, OK 74120 |
| Street Address |
3354 E 51ST ST |
| City | TULSA |
| State | OK |
| Zip Code | 74135-3512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215348891 | Osu Center for Health Sciences | Clinic/Center | 3354 E 51st St, Tulsa, OK 74135-3512 | 2014-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761590 | Dr. Whitney M. Ellsworth, Dpt, Pllc | Physical Therapist | 4185 S Harvard Ave, Suite E-1, Tulsa, OK 74135 | 2020-08-20 |
| 1942839089 | Kimberly Renee Gillens | Student in an Organized Health Care Education/Training Program | 4502 E 41st Street Obgyn Department, Tulsa, OK 74135 | 2020-04-01 |
| 1528525524 | Everest Pain Management | Clinic/Center | 4134 S Harvard Ave Suite B1, Tulsa, OK 74135 | 2019-02-26 |
| 1326524216 | Shelley Deeann Anderson | Technician | 7359 S 68th, Tulsa, OK 74135 | 2018-07-14 |
| 1811489065 | Taylor Diane Spears | Behavioral Analyst | 4835 S Fulton Ave Suite 104, Tulsa, OK 74135 | 2018-06-04 |
| 1225547821 | Heather Nicole Freed | Counselor | 4363 S Harvard Ave, Tulsa, OK 74135 | 2017-09-26 |
| 1306363924 | Danielle Walker | Case Manager/Care Coordinator | 3244 S Lakewood Ave Apt 4e, Tulsa, OK 74135 | 2017-08-24 |
| 1346766078 | Angels Place | Day Training, Developmentally Disabled Services | 3919 S. Oswego Avenue, Tulsa, OK 74135 | 2017-08-15 |
| 1659800019 | Welena-phay Kamamma Boren | Counselor | 4636 S Harvard Avenue, Tulsa, OK 74135 | 2017-06-08 |
| 1346774197 | Brandie Herren | Registered Nurse | 6333 E Skelly Drive, Tulsa, OK 74135 | 2017-04-19 |
| Find all providers in zip 74135 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871745802 | Tulsa Pediatric Urgent Care | Clinic/Center | 7717 E 91st St, Tulsa, OK 74133-6053 | 2008-10-22 |
| 1427234004 | American Current Care P.a. | Clinic/Center | 1541 North Sheridan Road, Tulsa, OK 74115 | 2008-01-14 |
| 1467817940 | Rodi LLC | Clinic/Center | 8316 E 61st St, Ste 101 A, Tulsa, OK 74133-1910 | 2015-12-28 |
| 1467836692 | Ahs Oklahoma Physician Group, LLC | Clinic/Center | 9245 S Mingo Rd, Tulsa, OK 74133-5793 | 2015-07-17 |
| 1780021576 | Statcare Clinics of Green Country LLC | Clinic/Center | 1217 E 48th St, Tulsa, OK 74105-4701 | 2013-06-03 |
| 1194000703 | My Doctor Immediate Care LLC | Clinic/Center | 7153 S Yale Ave, Tulsa, OK 74136-6308 | 2011-10-14 |
| 1114103793 | American Current Care Pa | Clinic/Center | 9515 E 51st St, Suite G, Tulsa, OK 75145 | 2008-01-14 |
| 1003918830 | St John Urgent Care Clinics Inc | Clinic/Center | 1923 S Utica Ave, Davis Tower 200, Tulsa, OK 74104-6520 | 2006-09-02 |
| 1306952593 | Statcare Clinics of Green Country LLC | Clinic/Center | 9716 Riverside Pkwy, Suite 100, Tulsa, OK 74137-7397 | 2006-08-22 |
| 1063479087 | Tulsa Emergency Medical Center Inc | Clinic/Center | 2929 S Garnett Rd, Tulsa, OK 74129-5101 | 2006-04-26 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on PEDISTAT, PLLC.
| 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.