IGNITE MEDICAL RESORT OKC, LLC (NPI# 1942801899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942801899 |
| Entity Type | Organization |
| Organization Name | IGNITE MEDICAL RESORT OKC, LLC |
| Practice Address |
6312 N Portland Ave Oklahoma City OK 73112-1463 |
| Mailing Address |
1550 N Northwest Hwy Ste 430 Park Ridge IL 60068-1461 |
| Practice Telephone | 4059466932 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | TIMOTHY FIELDS (CEO) |
| Authorized Official Telephone | 8474534000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316577679 | Ignite Medical Resort Okc, LLC | Skilled Nursing Facility | 6312 N Portland Ave, Oklahoma City, OK 73112-1463 | 2020-01-24 |
| Street Address |
6312 N PORTLAND AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-1463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326048695 | N-vest Skilled Nursing of Oklahoma, LLC | Nursing Facility/Intermediate Care Facility | 6312 N Portland Ave, Oklahoma City, OK 73112-1463 | 2005-07-28 |
| 1316577679 | Ignite Medical Resort Okc, LLC | Skilled Nursing Facility | 6312 N Portland Ave, Oklahoma City, OK 73112-1463 | 2020-01-24 |
| 1265742092 | Parcway | Skilled Nursing Facility | 6312 N Portland Ave, Oklahoma City, OK 73112-1463 | 2010-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982238077 | Integris Ambulatory Care Corporation | Clinic/Center | 11801 S May Ave, Oklahoma City, OK 73170-2560 | 2020-02-27 |
| 1245708957 | Integris Ambulatory Care Corporation | Clinic/Center | 7301 Sw 44th St Ste G, Oklahoma City, OK 73179-4308 | 2018-11-12 |
| 1568946119 | Integris Ambulatory Care Corporation | Clinic/Center | 11101 Hefner Pointe Dr Ste 207, Oklahoma City, OK 73120-5054 | 2018-09-19 |
| 1801819099 | Integris South Oklahoma City Corporation | Clinic/Center | 4100 S Douglas Ave, Oklahoma City, OK 73109-3210 | 2006-07-26 |
| 1992767867 | Select Physical Therapy Holdings Inc | Clinic/Center | 1634 Sw 122nd St, Oklahoma City, OK 73170-4859 | 2006-04-05 |
| 1386605905 | Select Physical Therapy Holdings Inc | Clinic/Center | 7000 Nw Expressway, Ste G, Oklahoma City, OK 73132-3509 | 2006-03-31 |
| 1902370687 | Integris Ambulatory Care Corp | Clinic/Center | 5520 N Independence Ave, Oklahoma City, OK 73112-5641 | 2019-01-16 |
| 1558858068 | James Jackson, Md LLC | Clinic/Center | 3330 Nw 56th St Ste 612, Oklahoma City, OK 73112-4470 | 2018-04-19 |
| 1447588348 | Health Resources | Clinic/Center | 1200 N Stonewall Ave, Oklahoma City, OK 73117-1215 | 2009-12-03 |
| 1740389626 | Board of Regents of The University of Oklahoma - Allied Health Clinics | Clinic/Center | 1200 N Stonewall Ave, Oklahoma City, OK 73117-1215 | 2006-09-21 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
Please comment or provide details below to improve the information on IGNITE MEDICAL RESORT OKC, LLC.
| 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.