Individual provider Active NPI

Holly Renee Lavender, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1184197899
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 392-4685
Fax
(918) 392-4693
NPI assigned
Jan 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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 Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6839 S Canton Ave
Tulsa, OK 74136-3402
Phone (918) 392-4685

Other practice location 1

10505 E 91st St Ste 208
Tulsa, OK 74133-5829
Phone (918) 494-8500

Other practice location 2

6151 S Yale Ave Ste 100A
Tulsa, OK 74136-1929
Phone (918) 494-8500

Other practice location 3

6151 S Yale Ave Ste 1304
Tulsa, OK 74136-1907
Phone (918) 494-8500

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
I20231016003542 OK Practitioner - Physician Assistant 7911352620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3028OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Nov 13, 2023 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

6151 S Yale Ave
Ste 1304
Tulsa, OK 74136
Phone (918) 494-5300

6151 S Yale Ave
Ste 100A
Tulsa, OK 74136
Phone (918) 494-2100

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

10505 E 91st St
Ste 208
Tulsa, OK 74133
Phone (918) 307-5470

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: hlavender104692@direct.saintfrancis.com

Organizations & group practices 2

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 7

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": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1184197899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6839 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363402",
            "telephone_number": "918-392-4685",
            "fax_number": "918-392-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-392-4685",
            "fax_number": "918-392-4693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10505 E 91st St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741335829",
            "country_code": "US",
            "telephone_number": "918-494-8500",
            "fax_number": "918-307-5578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6151 S Yale Ave Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361929",
            "country_code": "US",
            "telephone_number": "918-494-8500",
            "fax_number": "918-307-5578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6151 S Yale Ave Ste 1304",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361907",
            "country_code": "US",
            "telephone_number": "918-494-8500",
            "fax_number": "918-307-5578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "HOLLY",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.