NICHOLAS D DEBOLT (NPI# 1700122587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700122587 |
| Entity Type | Individual |
| Full Name | NICHOLAS D DEBOLT |
| Credential | PA-C |
| Practice Address |
2488 E 81st St Ste 290 Tulsa OK 74137-4265 |
| Practice Telephone | 9184942665 |
| Practice Fax Number | 9189273201 |
| Mailing Telephone | 9189273226 |
| Mailing Fax Number | 9189273193 |
| Enumeration Date | 2012-12-23 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2194 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200472630A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1809 E 13th St, Tulsa, OK 741044419 | 9185826100 |
| Street Address |
2488 E 81ST ST STE 290 |
| City | TULSA |
| State | OK |
| Zip Code | 74137-4265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679573844 | Bradford L Boone | Orthopaedic Surgery | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2005-07-28 |
| 1285241034 | Heather A Beloncik | Physical Therapy Assistant | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2020-09-25 |
| 1033756804 | Ladamian Kawon Wilson | Physical Therapist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2019-11-29 |
| 1174022008 | Ryan Michael Carter | Specialist/Technologist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2018-02-06 |
| 1851811137 | Taylor Caldwell | Physical Therapy Assistant | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2017-06-27 |
| 1558890681 | Talor Dee Fulps | Physical Therapist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2017-06-12 |
| 1285171157 | Kayla R Clark | Specialist/Technologist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2017-01-30 |
| 1235676453 | Advanced Orthopedics of Oklahoma Pllc | Orthopaedic Surgery | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2017-01-25 |
| 1447636550 | Tony Morakot | Physical Therapist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2015-07-31 |
| 1942632062 | Meagan Elizabeth Deshane | Specialist/Technologist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2013-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487493 | Christopher Thibeault | Physician Assistant | 10326 S Oswego Ave, Tulsa, OK 74137 | 2019-09-27 |
| 1851896237 | Leslie King | Nurse Practitioner | 4809 East 89th Street South, Suite 100, Tulsa, OK 74137 | 2018-03-27 |
| 1245756428 | Olakunle Ajanaku | Dentist | 4818 East 113th Place South, Tulsa, OK 74137 | 2017-08-18 |
| 1831610096 | Cameron Craig | Dentist | 9671 South Riverside Drive East, Tulsa, OK 74137 | 2017-06-28 |
| 1669915336 | Verum Health | Chiropractor | 5014 East 101st Street, Suite 200, Tulsa, OK 74137 | 2016-11-29 |
| 1518327014 | Richard A Felmlee | General Practice | 8955 S. College Place, Tulsa, OK 74137 | 2016-02-26 |
| 1164815395 | John F Carletti Dds Prof Corp | Dentist | 2808 E. 101st St., Tulsa, OK 74137 | 2015-03-12 |
| 1023356581 | The Bair Foundation | Exclusive Provider Organization | 2921 E. 91st St, Tulsa, OK 74137 | 2013-01-17 |
| 1588900328 | Isaac Newton Causey | Counselor | 9325 S. Erie Avenue, Tulsa, OK 74137 | 2012-12-26 |
| 1952656894 | Crystal I Phillips | Behavioral Analyst | 2921 E 91st, Tulsa, OK 74137 | 2012-07-17 |
| Find all providers in zip 74137 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578025094 | Shawna Rose Liszewski | Physician Assistant | 6767 S Yale Ave Ste A, Tulsa, OK 74136-3302 | 2019-04-03 |
| 1265920565 | Elite Surgical Assisting, LLC | Physician Assistant | 2924 S 98th East Ave, Tulsa, OK 74129-4407 | 2018-04-23 |
| 1417472259 | Brooke Javon Denton | Physician Assistant | 2924 S. 98th East Ave, Tulsa, OK 74129 | 2017-08-12 |
| 1265797781 | Rebecca Lynn Painter | Physician Assistant | 9915 E 82nd Pl, Tulsa, OK 74133-4557 | 2012-07-10 |
| 1003417411 | Erin Haley Sims | Physician Assistant | 6465 S Yale Ave Ste 101, Tulsa, OK 74136-7803 | 2020-11-03 |
| 1134779341 | Jarret Dwight Keller | Physician Assistant | 6767 S Yale Ave Ste A, Tulsa, OK 74136-3302 | 2019-09-19 |
| 1891253431 | Amy Nichole Ingham | Physician Assistant | 6161 S Yale Ave, Tulsa, OK 74136-1992 | 2019-03-02 |
| 1568984425 | Paramount Surgical Assisting | Physician Assistant | 9915 E 82nd Pl, Tulsa, OK 74133-4557 | 2017-07-12 |
| 1003352543 | Anne Claire Edmonds | Physician Assistant | 6565 S Yale Ave Ste 1200, Tulsa, OK 74136-8313 | 2017-01-09 |
| 1477971315 | The Orthopaedic Center | Physician Assistant | 8803 S 101st East Ave, Suite 100, Tulsa, OK 74133-5726 | 2014-03-28 |
| Find all providers in TULSA | ||||
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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.