PHEBE JOY SISTOSO (NPI# 1760030027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760030027 |
| Entity Type | Individual |
| Full Name | PHEBE JOY SISTOSO |
| Other Name | PHEBE JOY GRANDERSON |
| Credential | CNM |
| Practice Address |
4800 W San Antonio St Broken Arrow OK 74012-6127 |
| Practice Telephone | 9182502229 |
| Mailing Telephone | 9182502229 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
M115216 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
4800 W SAN ANTONIO ST |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-6127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982957064 | Bliss Dialysis LLC | Clinic/Center | 4800 W San Antonio St, Ste 200, Broken Arrow, OK 74012-6127 | 2012-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710349352 | Memorial Hospital of Texas County | Obstetrics & Gynecology | 401 N Polk Ave, Keyes, OK 73947 | 2016-03-23 |
| 1487040101 | Alyssa Mathilde Ohs | Obstetrics & Gynecology | 3400 W Tecumseh Rd Ste 205, Norman, OK 73072-1811 | 2015-04-09 |
| 1356339360 | Bryan Treacy | Obstetrics & Gynecology | 1035 Sw 19th St, Suite B, Moore, OK 73160-2883 | 2005-10-12 |
| 1982943536 | Memorial Hospital of Texas County Authority | Obstetrics & Gynecology | 421 Medical Dr, Guymon, OK 73942-3640 | 2013-02-01 |
| 1396082327 | Daran L. Parham, M.d., LLC | Obstetrics & Gynecology | 1725 E 19th St Ste 401, Tulsa, OK 74104-5409 | 2013-01-10 |
| 1689946360 | Marsha Nahra, Md, P.C. | Obstetrics & Gynecology | 6465 S Yale Ave, Ste 515, Tulsa, OK 74136-7823 | 2012-01-27 |
| 1124312004 | Jazmin Matlock Baker | Obstetrics & Gynecology | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2011-06-08 |
| 1003107863 | Marsha K. Howerton, Md, PC | Obstetrics & Gynecology | 6465 S Yale Ave, Suite 310, Tulsa, OK 74136-7823 | 2011-04-28 |
| 1881996155 | John R. Dosser, M.d., Inc. A Professional Corporation | Obstetrics & Gynecology | 3617 Nw 58th St, #200, Oklahoma City, OK 73112-4487 | 2010-11-18 |
| 1285951186 | Ryan Daniel Gholson | Obstetrics & Gynecology | 717 S Houston Ave Ste 200, Tulsa, OK 74127-9005 | 2010-05-01 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.