PARKSIDE, INC.


Address: 1620 E 12th St, Tulsa, OK 74120-5407
Phone: 9185822131

PARKSIDE, INC. (NPI# 1851327464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851327464
Entity Type Organization
Organization Name PARKSIDE, INC.
Other Organization Name PARKSIDE OUTPATIENT
Practice Address 1620 E 12th St
Tulsa
OK 74120-5407
Practice Telephone 9185822131
Mailing Telephone 9185822131
Enumeration Date 2006-06-24
Last Update Date 2012-10-31
Authorized Official Name MRS. SAUNYA D MOORE (CFO)
Authorized Official Telephone 9185822131
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0850X Clinic/Center
Specialization: Adult Mental Health
2261 OK Ambulatory Health Care Facilities
N 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
2261 OK Ambulatory Health Care Facilities
Y 283Q00000X Psychiatric Hospital 2261 OK Hospitals

Other Provider Identifier

State Issuer Identifier Type Code
OK CHAMPUS A00174120 01
OK BC/BS 000374005-001 01
OK 100738360C 05
OK 100738360B 05

Other Provider/Organization Names

Other Name Type Code
Parkside Outpatient Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1346461688 Parkside, Inc. Psychiatric Residential Treatment Facility 1619 E 13th St, Tulsa, OK 74120-5410 2007-05-02
1164643409 Parkside, Inc. Psychiatric Residential Treatment Facility 1220 S Trenton Ave, Tulsa, OK 74120-5421 2007-05-02
1437370772 Parkside, Inc. Psychiatric Hospital 1619 East 13th Street, Tulsa, OK 74120-5410 2007-05-02
1134750649 Parkside, Inc. Clinic/Center 1239 S Trenton Ave, Tulsa, OK 74120-5420 2020-02-03
1750714721 Parkside, Inc. Psychiatric Hospital 1619 E 13th St, Tulsa, OK 74120-5410 2013-08-14
1326396391 Parkside, Inc. Psychiatric Hospital 1220 S Trenton Ave, Tulsa, OK 74120-5421 2012-08-24
1205135936 Parkside, Inc. Psychiatric Unit 1220 S Trenton Ave, Tulsa, OK 74120-5421 2011-03-21
1548573348 Parkside, Inc. Clinic/Center 1220 S Trenton Ave, Tulsa, OK 74120-5421 2010-07-21
1356552111 Parkside, Inc. Clinic/Center 1620 E 12th St, Tulsa, OK 74120-5407 2007-05-24

Other Data Sources

Entity Type Entity Name Entity Address
Connecticut Business Registrations PARKSIDE, INC. 253 Amenia Union Road, Sharon, CT 06069
Oklahoma Business Registrations PARKSIDE, INC. 1620 E 12th St, Tulsa, OK 74120

Office Location

Street Address 1620 E 12TH ST
City TULSA
State OK
Zip Code 74120-5407

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396382883 Kaleb Redick Nurse Practitioner 1620 E 12th St, Tulsa, OK 74120-5407 2019-12-04
1982161568 James D Pollard Social Worker 1620 E 12th St, Tulsa, OK 74120-5407 2019-03-01
1942700497 Diana Lynn Tatro Case Manager/Care Coordinator 1620 E 12th St, Tulsa, OK 74120-5407 2018-02-20
1942616289 Michele Despain Registered Nurse 1620 E 12th St, Tulsa, OK 74120-5407 2014-07-08
1447663158 Frances Whisman Registered Nurse 1620 E 12th St, Tulsa, OK 74120-5407 2014-06-10
1316282684 Uchenna Okolonwamu Physician Assistant 1620 E 12th St, Tulsa, OK 74120-5407 2012-11-27
1316295470 Tina Cooper Counselor 1620 E 12th St, Tulsa, OK 74120-5407 2012-08-21
1639448079 William James List Social Worker 1620 E 12th St, Tulsa, OK 74120-5407 2011-12-14
1518235019 Rosemarie Capps Social Worker 1620 E 12th St, Tulsa, OK 74120-5407 2011-12-12
1538437140 Noel Patrick Harter Counselor 1620 E 12th St, Tulsa, OK 74120-5407 2011-12-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144704321 Quintella Delana Miller Case Manager/Care Coordinator 1043 E Easton St, Tulsa, OK 74120 2018-09-24
1689152092 Charles Granger Jr. Case Manager/Care Coordinator 103 N Greenwood, Suite 320, Tulsa, OK 74120 2018-07-30
1174015598 Debra Anne Beasley Counselor 1619 E. 13th St., Tulsa, OK 74120 2018-06-01
1649775701 Cara Marie Cantu Licensed Practical Nurse 620 South Peoria, Tulsa, OK 74120 2018-03-29
1639558745 Wei Te Li Student in an Organized Health Care Education/Training Program 1207 S Quaker Ave Apt 104, Tulsa, OK 74120 2015-05-21
1225434350 Marcos Rivero Community/Behavioral Health 130 N. Greenwood, Suite 302, Tulsa, OK 74120 2014-11-18
1861742348 Tamiika Jones Social Worker 1533 E 13th St, Apt B, Tulsa, OK 74120 2012-09-12
1730408097 Teresa Lee Henshaw Physical Therapist 1125 S. Trenton, Hillcrest Medical Center- Kaiser Rehab. Center, Tulsa, OK 74120 2010-05-26
1194970384 Kym Lynnette Lindsay Speech-Language Pathologist 1125 S Trenton Ave Fl 3, Tulsa, OK 74120 2008-12-01
1184872004 Board of Regents of The University of Oklahoma Ou Physicians Tulsa Pediatrics 619 S. Quincy Ave., Ouptch-laura Dester Shelter, Tulsa, OK 74120 2008-09-04
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Taxonomy Information

Taxonomy Code 283Q00000X
Grouping Hospitals
Classification Psychiatric Hospital

Taxonomy Definition

An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.
Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104224856 Erica Gregory Psychiatric Hospital 211 S Garnett Rd, Tulsa, OK 74128-1805 2014-12-11
1437370772 Parkside, Inc. Psychiatric Hospital 1619 East 13th Street, Tulsa, OK 74120-5410 2007-05-02
1982005971 Shadow Mountain Behavioral Health System, LLC Psychiatric Hospital 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2014-09-09
1902224801 Shadow Mountain Behavioral Health System, LLC Psychiatric Hospital 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2014-03-29
1750714721 Parkside, Inc. Psychiatric Hospital 1619 E 13th St, Tulsa, OK 74120-5410 2013-08-14
1174866875 Parkside Psychiatric Hospital & Clinic Psychiatric Hospital 1619 E 13th St, 1620 E. 12th, Tulsa, OK 74120-5410 2013-04-01
1326396391 Parkside, Inc. Psychiatric Hospital 1220 S Trenton Ave, Tulsa, OK 74120-5421 2012-08-24
1710296272 Shadow Mountain Behavioral Health Psychiatric Hospital 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2010-10-01
1891988424 John B White, Md PC Psychiatric Hospital 1620 E 12th St, Tulsa, OK 74120-5407 2007-08-27
1083807366 Oklahoma Medical and Psychiatric Services Inc Psychiatric Hospital 2913 E 88th St, Tulsa, OK 74137-2508 2007-08-21
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Competitor

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City TULSA
Zip Code 74120

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Dataset Information

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.

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