Individual provider Active NPI

Rachel Rhodes Dolan, P.A.-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1104852862
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
966 Issued in OK
Practice address
6475 S Yale Ave
#201
Tulsa, OK 74136-7816
Phone
(918) 499-2000
Fax
(918) 499-2188
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 966 OK Primary

Addresses

Primary practice location

6475 S Yale Ave
#201
Tulsa, OK 74136-7816

Mailing address

6475 S Yale Ave
#201
Tulsa, OK 74136-7816
Phone (918) 499-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000337 OK Practitioner - Physician Assistant 6608809058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1919 S Wheeling Ave
Tulsa, OK 74104-5634

Hospital & facility affiliations

  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • St John Owasso Hospital, Owasso, OK, CCN 370227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
966OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 31, 2022 Accepting new patients
Oklahoma Oncology & Hematology PC Past Accepting new patients
St John Medical Center Inc Past Accepting new patients
St. John Physicians, Inc. Past Accepting new patients

Locations

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1104852862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 S YALE AVE",
            "address_2": "#201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367816",
            "telephone_number": "918-499-2000",
            "fax_number": "918-499-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 S YALE AVE",
            "address_2": "#201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367816",
            "telephone_number": "918-499-2000",
            "fax_number": "918-499-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "RACHEL",
        "middle_name": "RHODES",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.