Organization Active NPI

Comprehensive Pain Management of Oklahoma, P.L.L.C.

  • Pain Medicine Physician
  • Yukon, OK
National Provider Identifier
1073992889
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
4373 Issued in OK
Legal business name
COMPREHENSIVE PAIN MANAGEMENT OF OKLAHOMA, P.L.L.C.
Practice address
432 S Mustang Rd Ste a
Yukon, OK 73099-7312
Phone
(405) 467-4399
Fax
(405) 467-4481
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Dr. Deborah Nilson, DONPI 1134135411
Title
Owner
Phone
(405) 568-2593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X 4373 OK Primary

Addresses

Primary practice location

432 S Mustang Rd Ste a
Yukon, OK 73099-7312

Mailing address

432 S Mustang Rd Ste a
Yukon, OK 73099-7312
Phone (405) 467-4399

Other identifiers 1

IdentifierTypeStateIssuer
200593290BMedicaidOK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2179695Comprehensive Pain Management of Oklahoma432 S Mustang Rd, Ste a, Yukon, OK 73099Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Locations

432 S Mustang Rd
Ste A
Yukon, OK 73099
Phone (405) 467-4399

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1073992889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 S MUSTANG RD STE A",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997312",
            "telephone_number": "405-467-4399",
            "fax_number": "405-467-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 S MUSTANG RD STE A",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997312",
            "telephone_number": "405-467-4399",
            "fax_number": "405-467-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PAIN MANAGEMENT OF OKLAHOMA, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "NILSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-568-2593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OK",
            "license": "4373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200593290B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.