AMARA GAYATHRI NANDIKOLLA (NPI# 1669745667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669745667 |
| Entity Type | Individual |
| Full Name | AMARA GAYATHRI NANDIKOLLA |
| Credential | MD |
| Practice Address |
1245 S Utica Ave Ste 100 Tulsa OK 74104 |
| Mailing Address |
1245 S Utica Ave Ste 100 Tulsa OK 74104-4214 |
| Practice Telephone | 9185793850 |
| Practice Fax Number | 9185793859 |
| Mailing Telephone | 9185793850 |
| Mailing Fax Number | 9185793859 |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
33755 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1245 S UTICA AVE STE 100 |
| City | TULSA |
| State | OK |
| Zip Code | 74104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578543260 | Andre Fredieu | Psychiatry & Neurology | 1245 S Utica Ave, 3rd Floor West, Tulsa, OK 74104-4214 | 2006-01-19 |
| 1356721237 | Devon Morris | Nurse Practitioner | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2015-06-04 |
| 1124426978 | Helen Hoggard | Registered Nurse | 1245 S Utica Ave, 2nd Floor East, Tulsa, OK 74104-4214 | 2014-12-10 |
| 1306264676 | Amy Clark | Nurse Practitioner | 1245 S Utica Ave, 3rd Floor West, Tulsa, OK 74104-4214 | 2014-04-02 |
| 1811314909 | Brandi Baxter | Nurse Practitioner | 1245 S Utica Ave, Suite 103, Tulsa, OK 74104-4214 | 2014-03-26 |
| 1649612847 | Laura Thornton Bloomfield | Nurse Practitioner | 1245 S Utica Ave, 2nd Floor West, Tulsa, OK 74104-4214 | 2013-07-29 |
| 1659539401 | Hillary Pane | Family Medicine | 1245 S Utica Ave, 2w, Tulsa, OK 74104-4214 | 2008-05-29 |
| 1003001785 | Jaclyn Cinda Jones | Orthopaedic Surgery | 1245 S Utica Ave, Tulsa, OK 74104 | 2007-09-06 |
| 1629283114 | Ahs Oklahoma Physician Group, LLC | Internal Medicine | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2007-05-10 |
| 1477766616 | Andrea Elizabeth Stafford | Internal Medicine | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2007-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730403882 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1810 E 15th St, Tulsa, OK 74104-4611 | 2010-03-18 |
| 1093782245 | John L. Eckenrode | Internal Medicine | 11212 E 48th St, Tulsa, OK 74146 | 2006-03-07 |
| 1255334496 | Barry Clinton Mirtsching | Internal Medicine | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2005-05-23 |
| 1376969378 | Oncology Physicians LLC | Internal Medicine | 7107 S Yale Ave, No,198, Tulsa, OK 74136-6308 | 2014-03-14 |
| 1568721033 | Jessica Ann Kreitzberg | Internal Medicine | 11212 E 48th St, Tulsa, OK 74146-5824 | 2012-05-03 |
| 1336406685 | Chelsea Nicole Thomas | Internal Medicine | 11212 E 48th St, Tulsa, OK 74146 | 2012-04-11 |
| 1083920425 | Nikhil Mukhi | Internal Medicine | 11212 E 48th St, Tulsa, OK 74146-5824 | 2010-08-24 |
| 1235398066 | Laura K Brett | Internal Medicine | 1809 E 13th St, Suite 402, Tulsa, OK 74104-4419 | 2008-06-06 |
| 1770790289 | Supriya Koya | Internal Medicine | 1919 S Wheeling Ave, Ste 204, Tulsa, OK 74104-5638 | 2007-05-16 |
| 1326145962 | Richard Charles Staab | Internal Medicine | 1810 E 15th St, Tulsa, OK 74104-4611 | 2006-09-17 |
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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.