SE EMS of Oklahoma, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS-459 Issued in OK

Legal business name

SE EMS OF OKLAHOMA, LLC

Doing business as

Southeast EMS

Practice address

30177 W Choctaw Rd
Stigler, OK 74462-3558

Phone

(479) 243-9819

NPI assigned

Aug 18, 2010

Last updated

Mar 16, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Connie J Newbolt

Title

President

Phone

(918) 315-0886

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SOUTHEAST EMS Doing business as

Locations

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1073828737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1800",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531800",
            "telephone_number": "479-243-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30177 W CHOCTAW RD",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744623558",
            "telephone_number": "479-243-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE EMS OF OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "NEWBOLT",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-315-0886",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AR",
            "license": "803",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS-479",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS-459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200412300A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210183715",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHEAST EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lawanda Sue Scarberry
• Elsie F Schoggins
• Patricia Darlene Scott-Marsh, R.N.
• Dorothy Lee Scott, CNP
• Summer Ashli Scott
• Jack N Sellers, DDS
• Shearwood Chiropractic Clinic Inc
• Colton Mark Shearwood, D.C.
• Martin Chance Shearwood, D.C.
• Martin E Shearwood, D.C.

• Land Ambulance in Stigler, OK
• Providers in Stigler, OK by specialty
• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.