Bethany Perfusion, PC

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

LP22 Issued in OK

Legal business name

BETHANY PERFUSION, PC

Practice address

3612 N Flamingo Ave
Bethany, OK 73008-3664

Phone

(405) 787-2677

Fax

(405) 787-2677

NPI assigned

Nov 7, 2006

Last updated

Aug 22, 2020By 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

Mr. Michael J. Massoni, B.S., C.C.P., L.P.NPI 1750450474

Title

President

Phone

(405) 787-2677

Specialties & licenses 1

Addresses

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.

• Michael J. Massoni, B.S., C.C.P., L.P

  • Surgical Technologist
  • Bethany, OK
  • NPI 1750450474
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093884769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 N FLAMINGO AVE",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730083664",
            "telephone_number": "405-787-2677",
            "fax_number": "405-787-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 N FLAMINGO AVE",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730083664",
            "telephone_number": "405-787-2677",
            "fax_number": "405-787-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY PERFUSION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASSONI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-787-2677",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S., C.C.P., L.P."
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "OK",
            "license": "LP22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collin Michael Berkman
• Kali Bernhard, M.A., CCC-SLP
• Bethany Dental Group PLLC (Bethany Dental Group)
• Bethany Foot Clinic LTD
• Bethany Medical Clinic, PLLC
• Bethany Public Schools
• Bethany United Drug Co (Bethany Drug)
• Tanya Billingsley
• Rachel Blevins
• Meredith Storm Bolt, PA

• Surgical Technologist in Bethany, OK
• Providers in Bethany, OK by specialty
• Surgical Technologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.