Timothy Bushyhead (NPI# 1154718807, PAC ID# 8123379419) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1154718807 |
| PAC ID by PECOS | 8123379419 |
| Professional Enrollment ID | I20180926000547 |
| Full Name | Timothy Bushyhead |
| Organization Legal Name | OMNI MEDICAL GROUP INC |
| Address |
1923 S Utica Ave Tulsa OK 74104-6520 |
| Phone Number | 9187442967 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9739080490 |
| Number of Group Practice Members | 91 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370227 | ST JOHN OWASSO |
| 370114 | ST JOHN MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 1923 S Utica Ave, Tulsa, OK 74104-6520 | 9187442967 | OMNI MEDICAL GROUP INC |
| Organization Legal Name | OMNI MEDICAL GROUP INC |
| Physicians | 96 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Goldameir Akingbola | Family Medicine | Omni Medical Group Inc | 1021 E Bryan Ave, Sapulpa, OK 74066-4512 |
| Mitzi Blanchard | Nurse Practitioner | Omni Medical Group Inc | 1421 E 13th St, Tulsa, OK 74120-5207 |
| Kelly R Wratten | Nurse Practitioner | Omni Medical Group Inc | 8115 S Memorial Dr, Tulsa, OK 74133-4331 |
| Ana Trujillo | Nurse Practitioner | Omni Medical Group Inc | 4720 S Harvard Ave, Suite 100, Tulsa, OK 74135-3023 |
| Michael H Vu | Family Medicine | Omni Medical Group Inc | 800 W Boise Cir, Suite 160, Broken Arrow, OK 74012-4932 |
| Brian T Crotty | Family Medicine | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| David L Smith | Family Medicine | Omni Medical Group Inc | 13600 E 86th St N, Suite 100, Owasso, OK 74055-8732 |
| Michelle Green | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Monica A Lee | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Patricia Duffy-feins | Clinical Social Worker | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Street Address |
1923 S UTICA AVE |
| City | TULSA |
| State | OK |
| Zip | 74104-6520 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian T Crotty | Family Medicine | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Terence L Carey | Allergy/immunology | T.l. Carey, M.d. and Associates, Inc. | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Tara A Mccants | Certified Registered Nurse Anesthetist (crna) | St. John Anesthesia Services, Inc. | 1923 S Utica Ave, St John Medical Center, Tulsa, OK 74104-6520 |
| Michelle Green | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Monica A Lee | Physician Assistant | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Patricia Duffy-feins | Clinical Social Worker | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Brad W Stahlheber | Anesthesiology | St. John Anesthesia Services, Inc. | 1923 S Utica Ave, St John Medical Center, Tulsa, OK 74104-6520 |
| Jon Pat Cox | Internal Medicine | Omni Medical Group Inc | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Daron V Brabham | Certified Registered Nurse Anesthetist (crna) | St. John Anesthesia Services, Inc. | 1923 S Utica Ave, St John Medical Center, Tulsa, OK 74104-6520 |
| Ryan T Hladky | Anesthesiology Assistant | St. John Anesthesia Services, Inc. | 1923 S Utica Ave, St John Medical Center, Tulsa, OK 74104-6520 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristin Patrick | Optometry | Oklahoma Vision Development Center | 111 S Lewis Ave, Tulsa, OK 74104-1616 |
| Monte Harrel | Optometry | Oklahoma Vision Development Center | 111 S Lewis Ave, Tulsa, OK 74104-1616 |
| Curtis V Wolf Ii | Ophthalmology | 1145 S Utica Ave, Suite 362, Tulsa, OK 74104-4004 | |
| Kay L Worley | Neurology | Neuro Links of Tulsa, L.L.C. | 1145 S Utica Ave, Suite 901, Tulsa, OK 74104-4005 |
| Gabriela Corsi Vasquez | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Sristi Bhattarai | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Stephan Hambaz | Infectious Disease | Thi Specialists LLC | 1145 S Utica Ave, Suite G12, Tulsa, OK 74104-4009 |
| Zubair Ashraf | Rheumatology | 1145 S Utica Ave, Suite 1109, Tulsa, OK 74104-4010 | |
| Michelle M Pieratt | Anesthesiology | Emergenchealth LLC | 1120 S Utica Ave, Hc Med Ctr, Tulsa, OK 74104-4012 |
| Ivan Kozhulenko | Certified Registered Nurse Anesthetist (crna) | Emergenchealth LLC | 1120 S Utica Ave, Hc Med Ctr, Tulsa, OK 74104-4012 |
| Find all physicians in zip 74104 | |||
| City | TULSA |
| Zip Code | 74104 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TULSA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Timothy Bushyhead.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.