Organization Active NPI

Pain Institute of Tulsa, Inc

  • Specialist
  • Tulsa, OK
National Provider Identifier
1124139126
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1732 Issued in OK
Legal business name
PAIN INSTITUTE OF TULSA, INC
Practice address
1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4004
Phone
(918) 496-5195
Fax
(918) 496-5194
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Raymond F Sorensen, DO
Title
Owner
Phone
(918) 496-5195

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 1732 OK Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 1434 OK

Addresses

Primary practice location

1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4004

Mailing address

1145 S Utica Ave
Suite 364
Tulsa, OK 74104-4004
Phone (918) 496-5195

Other identifiers 1

IdentifierTypeStateIssuer
200088040AMedicaidOK

National Provider Directory

National Provider Directory

Locations

2448 E 81st St
Ste 1200
Tulsa, OK 74137
Phone (918) 496-5195

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1124139126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 364",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044004",
            "telephone_number": "918-496-5195",
            "fax_number": "918-496-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 364",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044004",
            "telephone_number": "918-496-5195",
            "fax_number": "918-496-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN INSTITUTE OF TULSA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-496-5195",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "1732",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "1434",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200088040A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.