ST JOHN CARDIOVASCULAR MEDICINE INC (NPI# 1790717270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790717270 |
| Entity Type | Organization |
| Organization Name | ST JOHN CARDIOVASCULAR MEDICINE INC |
| Practice Address |
1923 E 21st St Suite 200 Tulsa OK 74114-1419 |
| Practice Telephone | 9187446966 |
| Practice Fax Number | 9187449642 |
| Mailing Telephone | 9187446966 |
| Mailing Fax Number | 9187449642 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-11-29 |
| Authorized Official Name | MR. LEX ANDERSON (VICE-PRESIDENT) |
| Authorized Official Telephone | 9187443674 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | RR MEDICARE | DE4213 | 01 |
| Street Address |
1923 E 21ST ST SUITE 200 |
| City | TULSA |
| State | OK |
| Zip Code | 74114-1419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629299987 | Kristen Michelle Floyd | Dietitian, Registered | 1923 E 21st St, Tulsa, OK 74114-1402 | 2007-05-02 |
| 1235154253 | Jose Medina | Internal Medicine | 1923 E 21st St, Suite 200, Tulsa, OK 74114-1419 | 2006-07-12 |
| 1073538005 | Richard Raines | Internal Medicine | 1923 E 21st St, Suite 200, Tulsa, OK 74114-1419 | 2006-07-12 |
| 1346274990 | William Burnett | Internal Medicine | 1923 E 21st St, Suite 200, Tulsa, OK 74114-1419 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356865307 | Helen Marie Collier | Registered Nurse | 2325 S. Harvard Avenue, Tulsa, OK 74114 | 2017-08-01 |
| 1730635640 | Portia Resnick | Specialist/Technologist | 5707 E 24th Pl, Tulsa, OK 74114 | 2016-08-31 |
| 1093177925 | Ana Achlosser | Counselor | 2120 S Jamestown Ave, Tulsa, OK 74114 | 2016-03-21 |
| 1437558277 | Nicole Holzkamper | Case Manager/Care Coordinator | 2525 S Harvard Ave, Tulsa, OK 74114 | 2014-08-18 |
| 1619216272 | Nicole Lisette Mancinelli | Physician Assistant | 2424 E. 21st Street, Suite 320, Tulsa, OK 74114 | 2013-02-01 |
| 1598001414 | Zachary Paschall | Counselor | 2325 S Havard Ave, Tulsa, OK 74114 | 2012-12-20 |
| 1346511334 | Chelsea Lee Joslin | Counselor | 2140 S Harvard Ave Ste 200, Tulsa, OK 74114 | 2012-01-23 |
| 1073893210 | Elizabeth C Canfield | Speech-Language Pathologist | 1929 South 74th East Avenue, Tulsa, OK 74114 | 2011-08-19 |
| 1508185430 | Karly Lynn Mason | Social Worker | 2140 S. Harvard, Tulsa, OK 74114 | 2010-05-17 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| Find all providers in zip 74114 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801355813 | Tulsa Cardiovascular Center of Excellence, L.l.c | Internal Medicine | 11912 S Norwood Ave Ste 105, Tulsa, OK 74137-5509 | 2019-03-19 |
| 1356621353 | Taraka Vijaya Rama Raju Gadiraju | Internal Medicine | 6151 S Yale Ave Ste 1-304, Tulsa, OK 74136-1907 | 2011-08-22 |
| 1174750749 | Matthew Joseph Comstock | Internal Medicine | 11912 S Norwood Ave Ste 110, Tulsa, OK 74137-5509 | 2009-06-22 |
| 1497965818 | Heart Care of Tulsa, Inc. | Internal Medicine | 802 South Jackson, Suite 225, Tulsa, OK 74127 | 2007-05-23 |
| 1528152899 | Cardiovascular Consultants Inc | Internal Medicine | 5555 E 71 Street, Suite 7200, Tulsa, OK 74136-6544 | 2006-10-03 |
| 1598719775 | Richard Lynn Irvin | Internal Medicine | 6151 S Yale Ave Ste 100a, Tulsa, OK 74136-1929 | 2006-05-20 |
| 1578524013 | Gregory Mcwilliams | Internal Medicine | 5555 E 71st St, Ste 7200, Tulsa, OK 74136 | 2006-03-31 |
| 1922080860 | David Matthew Wilkett | Internal Medicine | 802 S Jackson Ave Ste 225, Tulsa, OK 74127-9049 | 2005-11-16 |
| 1194727164 | James Ray Higgins | Internal Medicine | 7912 E 31st Ct, Suite 320, Tulsa, OK 74145-1305 | 2005-08-10 |
| 1619976776 | William Bruce Ross | Internal Medicine | 6151 S Yale Ave Ste 1304, Tulsa, OK 74136-1907 | 2005-07-20 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on ST JOHN CARDIOVASCULAR MEDICINE INC.
| 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.