Provision Cares Proton Center Okc, LLC

Primary specialty

Radiation Oncology Clinic/CenterTaxonomy code 261QX0203X

Legal business name

PROVISION CARES PROTON CENTER OKC, LLC

Doing business as

Provision Cares Proton Center OKC, LLC

Practice address

5901 W Memorial Rd
Oklahoma City, OK 73142-2015

Phone

(865) 342-4518

NPI assigned

Jun 22, 2018

Organization subpart

No

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

Authorized official

Name

Valerie Gibbs

Title

Director of Business Operations

Phone

(865) 342-4518

Specialties & licenses 1

Addresses

Other names 1

• Provision Cares Proton Center OKC, LLC Doing business as

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529625600000",
    "number": "1083109037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 PROVISION CARES WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092544",
            "telephone_number": "865-342-4518",
            "fax_number": "865-321-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422015",
            "telephone_number": "865-342-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION CARES PROTON CENTER OKC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "865-342-4518"
    },
    "taxonomies": [
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provision Cares Proton Center OKC, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan N. Proud, D.D.S.
• Tyler Jay Prouty
• Providence Family Practice, PLLC
• Providence Home Care LLC
• Provincial Home Care (Community Hospice of Oklahoma)
• Provision Medical Supplies, Inc.
• Jessica Rae Provost, APRN
• Maria Gabriella Prudhomme, NP
• Geoffrey Allen Pruett, D.M.D.
• Pruett'S Food, Inc. (Buy for Less Pharmacy (Pruett's Lake Hefner))

• Radiation Oncology Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Radiation Oncology Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.