Active NPI
Pono Neuromonitoring, PLLC
- Clinical Neurophysiology Physician
- Oklahoma City, OK
National Provider Identifier
1013379627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neurophysiology Physician
- Legal business name
- PONO NEUROMONITORING, PLLC
- Practice address
- 3110 S.W. 89TH St
Suite 200 E
Oklahoma City, OK 73159 - Phone
- (210) 598-4277
- NPI assigned
- Mar 23, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Roxanna Laroque III
- Title
- Director of Client Experience
- Phone
- (210) 598-4277
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electrodiagnostic Medicine Physician | 204R00000X | |||
| Neurology Physician | 2084N0400X | |||
| Clinical Neurophysiology Physician | 2084N0600X | Primary | ||
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X |
Addresses
Primary practice location
3110 S.W. 89TH St
Suite 200 E
Oklahoma City, OK 73159
Mailing address
1141 N Loop 1604 E #105-612
San Antonio, TX 78232
Phone (210) 598-4277
National Provider Directory
National Provider DirectoryLocations
3334 W Main St
Norman, OK 73072
Phone (405) 561-2201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663891200000",
"number": "1013379627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 N LOOP 1604 E #105-612",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78232",
"telephone_number": "210-598-4277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3110 S.W. 89TH ST",
"address_2": "SUITE 200 E",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73159",
"telephone_number": "210-598-4277"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PONO NEUROMONITORING, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-23",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A",
"authorized_official_last_name": "LAROQUE",
"authorized_official_first_name": "ROXANNA",
"authorized_official_title_or_position": "DIRECTOR OF CLIENT EXPERIENCE",
"authorized_official_telephone_number": "210-598-4277",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "204R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Electrodiagnostic Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": null,
"license": null,
"primary": true
},
{
"code": "246ZE0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.