Active NPI
Jonathan D Friend, MD
- Anesthesiology Physician
- Tulsa, OK
National Provider Identifier
1043205453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 12707
- Practice address
- 4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229 - Phone
- (918) 728-6194
- Fax
- (918) 664-2521
- NPI assigned
- Sep 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 12707 | OK | Primary |
Addresses
Primary practice location
4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Mailing address
4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone (918) 728-6194
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 721545605-001 | Other | OK | BCBS |
| 4055199 | Other | OK | AETNA |
| 100105450A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12707 | OK | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1043205453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 S GARNETT RD",
"address_2": "STE 919",
"city": "TULSA",
"state": "OK",
"postal_code": "741465229",
"telephone_number": "918-728-6194",
"fax_number": "918-664-2521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S GARNETT RD",
"address_2": "STE 919",
"city": "TULSA",
"state": "OK",
"postal_code": "741465229",
"telephone_number": "918-728-6194",
"fax_number": "918-664-2521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEND",
"first_name": "JONATHAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OK",
"license": "12707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "721545605-001",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4055199",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100105450A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.