East Tulsa Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1567 Issued in OK

Legal business name

EAST TULSA MEDICAL GROUP

Practice address

11445 E 20TH St
Tulsa, OK 74128-6421

Phone

(918) 437-6830

Fax

(918) 437-6171

NPI assigned

Aug 11, 2014

Organization subpart

No

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

Authorized official

Name

Jeff A Barentine, PA

Title

Partner

Phone

(918) 437-6830

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.

• Jeffery Allen Barentine, PA-C

  • Physician Assistant
  • Coweta, OK
  • NPI 1104997436
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1114336534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 E 20TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741286421",
            "telephone_number": "918-437-6830",
            "fax_number": "918-437-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 E 20TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741286421",
            "telephone_number": "918-437-6830",
            "fax_number": "918-437-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TULSA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "BARENTINE",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "918-437-6830",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanne Early, RN
• Melissa L Earnest, M.A.
• Dianna Earnhardt, CDT
• Danielle J Easley
• James Easley, M.D.
• East West Integrated Care Center LLC (Maplebrook Acupuncture Center LLC)
• Angela M Easter, MS, LPC
• Phillip William Easterly, PT
• Eastern Oklahoma Center for Women Inc
• Eastern Oklahoma Chiropractic, PLLC

• Family Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.