Oasis Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OASIS MEDICAL GROUP, LLC

Practice address

2035 Mesquite Ave
Suite C
Lake Havasu City, AZ 86403-5894

Phone

(928) 453-1101

Fax

(928) 453-1171

NPI assigned

Jul 8, 2010

Organization subpart

No

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

Authorized official

Name

Nicole Mitchell

Title

Owner

Phone

(928) 453-1101

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2704/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1114239019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1185",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051185",
            "telephone_number": "928-453-1101",
            "fax_number": "928-453-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 MESQUITE AVE",
            "address_2": "SUITE C",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035894",
            "telephone_number": "928-453-1101",
            "fax_number": "928-453-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OASIS MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-453-1101"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LLC REGISTRATION",
            "identifier": "L-1602910-3",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535744",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Novelen
• Glenn L Nudelman, M.D.
• Nuderm Treatment Center LLC
• Kylee Nusbaum, PTA
• Shawn Robert O'Haver, AG-ACNP
• Karen Ann Olsavsky, SLPA
• One Bridge Surgical, PLLC
• One Touch Med Alert LLC
• Jonathan K Oneill, PT, DPT
• Angelo Ong-Veloso Jr., M.D.

• Family Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.