Individual provider Active NPI

Edie Ann Carey, D.O.

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1104142843
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
5063 Issued in OK
Practice address
1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4000
Phone
(918) 579-5749
Fax
(918) 579-5762
NPI assigned
Apr 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 5063 OK Primary

Addresses

Primary practice location

1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4000

Mailing address

1145 S Utica Ave
Ste 460
Tulsa, OK 74104-4000
Phone (918) 579-5749

Other identifiers 1

IdentifierTypeStateIssuer
200345230BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130802000464 OK Practitioner - HospitalistPractitioner - Family Practice 1951542919 Reassigns benefits to 2 organizations
I20220824000998 TX Practitioner - HospitalistPractitioner - Family Practice 1951542919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5063OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thi Specialists LLC Hospitalist CurrentSince Aug 13, 2017 Accepting new patients
Tulsa Hospital Medicine Physicians Group, LLC CurrentSince Feb 1, 2022 Accepting new patients
Lawton Indian Hospital CurrentSince Apr 7, 2025 Accepting new patients

Locations

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1145 S Utica Ave
Ste 460
Tulsa, OK 74104
Phone (918) 392-8884

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

2440 E 81st St
Tulsa, OK 74137
Phone (918) 392-8856

Organizations & group practices 3

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1104142843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "EDIE",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "5063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200345230B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.