QT Quikmed LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

QT QUIKMED LLC

Practice address

4705 S 129TH East Ave
Tulsa, OK 74134-7005

Phone

(918) 994-3953

NPI assigned

Apr 28, 2021

Organization subpart

Yes

Parent organization

QUIKTRIP CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carolyn Barton

Title

Provider Relations Manager

Phone

(918) 994-3953

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek A Fickenscher, MD

  • Emergency Medicine Physician
  • Overland Park, KS
  • NPI 1477510030
  NPD (past)
• Margurite Isaac, NP

  • Family Nurse Practitioner
  • Aurora, CO
  • NPI 1336635598
  NPD (past)
• Sean Michael Martin, PA-C

  • Medical Physician Assistant
  • Kansas City, MO
  • NPI 1568050102
  NPD (past)
• Eric Nalagan, M.D.

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1033287610

  Family Medicine

  NPD (past)
• Jeffrey Allen Scott, MD

  • Family Medicine Physician
  • Belton, MO
  • NPI 1386645471

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1013590074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 S 129TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741347005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 S 129TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741347005",
            "telephone_number": "918-994-3953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6700 College Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662111525",
            "country_code": "US",
            "telephone_number": "913-693-7198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2360 Armour Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641163261",
            "country_code": "US",
            "telephone_number": "816-490-4025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "822 Quik Trip Way",
            "address_purpose": "LOCATION",
            "city": "Belton",
            "state": "MO",
            "postal_code": "640124658",
            "country_code": "US",
            "telephone_number": "816-425-3703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "QT QUIKMED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIKTRIP CORPORATION",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "918-994-3953"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dipa Puwar, DO
• Kathryn Lee Pyle, LCSW
• Sharon C Pyle, LPC
• Tara McGahan Pyle, PH.D.
• Vanlinh Pham Pyle, M.D.
• Trang Thi Quach, CRNA
• Quality Care Medical Center Inc
• Quality First Medical Supplies LLC
• Quality First Medical Supplies LLC
• Quality Mobile Medical Imaging LLC

• All providers in Tulsa, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.