Individual provider Active NPI

Lori D Rule, PA C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1073596433
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
658 Issued in OK
Practice address
1516 S Yorktown PL
Tulsa, OK 74104-4918
Phone
(918) 712-8888
Fax
(918) 712-8892
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 658 OK Primary

Addresses

Primary practice location

1516 S Yorktown PL
Tulsa, OK 74104-4918

Mailing address

1516 S Yorktown PL
Tulsa, OK 74104-4918
Phone (918) 712-8888

Other identifiers 1

IdentifierTypeStateIssuer
100114540BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120201000346 OK Practitioner - Physician Assistant 8022275122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Dermatology PLLCGroup PAC ID 9234487554, 11 clinicians

Practice addresses (Care Compare)

720 W 71St St
Tulsa, OK 74132-1825
Phone (918) 760-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
658OKMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Dermatology PLLC CurrentSince Aug 9, 2021 Accepting new patients

Locations

6966 S Utica Ave
Ste 225
Tulsa, OK 74136
Phone (855) 492-6333

5801 E 41st St
Ste 200
Tulsa, OK 74135
Phone (918) 293-9966

720 W 71st St
Tulsa, OK 74132
Phone (918) 760-0700

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00426
  • FHIR API: https://api.platform.athenahealth.com/27261/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1073596433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 S YORKTOWN PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044918",
            "telephone_number": "918-712-8888",
            "fax_number": "918-712-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 S YORKTOWN PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044918",
            "telephone_number": "918-712-8888",
            "fax_number": "918-712-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULE",
        "first_name": "LORI",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114540B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.