DR. KRISTIN LEE WILLS (NPI# 1710921929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710921929 |
| Entity Type | Individual |
| Full Name | DR. KRISTIN LEE WILLS |
| Other Name | DR. KRISTIN LEE TALLA |
| Credential | D.O. |
| Practice Address |
1923 S Utica Ave St John Emergency Dept Tulsa OK 74104-6520 |
| Practice Telephone | 9187443528 |
| Practice Fax Number | 9187443529 |
| Mailing Telephone | 9187443528 |
| Mailing Fax Number | 9187443529 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2014-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 3995 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1923 S UTICA AVE ST JOHN EMERGENCY DEPT |
| City | TULSA |
| State | OK |
| Zip Code | 74104-6520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174527667 | Mark Douglas Mills | Pharmacist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2005-06-13 |
| 1043848880 | Saba Imani | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-03-28 |
| 1073146312 | Tammy Irene Joplin | Clinical Nurse Specialist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-02-14 |
| 1962047563 | Houston Reed Slemp | Nurse Practitioner | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-11-07 |
| 1558903369 | Nicole Coburn | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-14 |
| 1124669643 | Jordan Beasley | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-06 |
| 1558926683 | Jacob Blasdel | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-05-03 |
| 1487217634 | Candice R Rogers | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-04-15 |
| 1881158178 | Ellen Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
| 1528522810 | Hannah Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
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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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457715799 | John Carl Sacra | Emergency Medicine | 7911 S. Hudson Pl, Tulsa, OK 74136 | 2016-04-13 |
| 1730568965 | Brianne C Roepke | Emergency Medicine | 744 West 9th St, Tulsa, OK 74127-9028 | 2015-05-20 |
| 1164818993 | Theresa Jackson | Emergency Medicine | 4629 E 13th Pl, Tulsa, OK 74112-6103 | 2015-04-08 |
| 1710371448 | Medexpress Urgent Care, PC - Oklahoma | Emergency Medicine | 2140 S Yale Avenue, Tulsa, OK 74114-2122 | 2015-03-19 |
| 1992148407 | Kevin Thomas Kierl | Emergency Medicine | 1145 S Utica Ave Fl 6, Tulsa, OK 74104-4000 | 2013-04-15 |
| 1467715300 | Mednow Urgent Care Center LLC | Emergency Medicine | 7127 S Olympia, Tulsa, OK 74132 | 2012-06-15 |
| 1437457009 | Matthew Jenkins | Emergency Medicine | 20 E 5th St Ste 620, Tulsa, OK 74103-4441 | 2011-03-07 |
| 1073819314 | Shane Marshall | Emergency Medicine | 4813 S 187th East Ave, Tulsa, OK 74134-7203 | 2011-02-03 |
| 1316178874 | Wyatt-dean Avery Pickering | Emergency Medicine | 1223 S Lawton Ave, Tulsa, OK 74127-9173 | 2009-08-01 |
| 1891959581 | Michael Richard Schiesel | Emergency Medicine | 1923 S Knoxville Ave, Tulsa, OK 74112-6841 | 2008-07-11 |
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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.