Julie Blizzard, D.O.
Individual provider Active NPI Pediatrics Physician · Tulsa, OK
NPI 1053774299 · NPPES record last updated Oct 31, 2019
Key facts
- NPI
- 1053774299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 6237 (OK)
- Practice address
- 4444 E 41St St
Tulsa, OK 74135-2527 - Phone
- (918) 619-4400
- Fax
- (918) 619-4334
- NPI assigned
- Apr 4, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210317000813 | OK | Practitioner - Pediatric Medicine | 4284040239 | Reassigns benefits to 1 organization |
| I20220826003078 | TX | Practitioner - Pediatric Medicine | 4284040239 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Nation Hospital & Clinics | Pediatrics | Current | Accepting new patients |
| Creek Nation Hospital & Clinics | Current |
Accepting new patients | |
| Creek Nation Hospital & Clinics | Current |
Accepting new patients | |
| Creek Nation Hospital & Clinics | Current |
Accepting new patients | |
| Creek Nation Hospital & Clinics | Past | Accepting new patients |
Locations
900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448
1313 E 20th St
Okmulgee, OK 74447
Phone (918) 591-5700
1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310
Dept 1467
Tulsa, OK 74182
10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760
Interoperability endpoints
- jblizzard19557@muscogeecreeknation.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 6237 | OK | Yes |
Addresses
Primary practice location
4444 E 41St St
Tulsa, OK 74135-2527
Mailing address
4502 E 41St St
Tulsa, OK 74135-2536
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200652270B | Medicaid | OK |
Other names
- Julie Putman
Other providers in Tulsa, OK
- Madisson Blish
- Abigail Louise Bliss
- Manda Lynn Bliss
- Natalie Kathryn Bliss
- Sarah Ann Bliss
- BLJ Counseling and Consulting PC
- Douglas E. Block
- Abby Laine Blondin
- Jeffery James Blonsky
- Bloom Pediatrics PLLC
All providers in Tulsa, OK · Pediatrics Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.