NPIMap

Organization Active NPI

National Community Dev Corp of Ok

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Tulsa, OK
National Provider Identifier
1184978512
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
7669 Issued in OK
Legal business name
NATIONAL COMMUNITY DEV CORP OF OK
Doing business as
NCDC of OK
Practice address
3115 S Winston Ave
Tulsa, OK 74135-2028
Phone
(918) 585-2233
Fax
(918) 585-2513
NPI assigned
Nov 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Authorized official

Name
Jim Fluegel, PH.D.
Title
Executive Director
Phone
(918) 585-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 7669 OK Primary

Addresses

Primary practice location

3115 S Winston Ave
Tulsa, OK 74135-2028

Mailing address

3115 S Winston Ave
Tulsa, OK 74135-2028
Phone (918) 585-2233

Other identifiers 1

IdentifierTypeStateIssuer
100630490KMedicaidOK

Other names 1

  • NCDC of OK Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Community Dev Corp of Ok9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3115 S Winston Ave
Tulsa, OK 74135
Phone (918) 585-2233

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1184978512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 S WINSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352028",
            "telephone_number": "918-585-2233",
            "fax_number": "918-585-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S WINSTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352028",
            "telephone_number": "918-585-2233",
            "fax_number": "918-585-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL COMMUNITY DEV CORP OF OK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "FLUEGEL",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "918-585-2233",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": "7669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100630490K",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCDC of OK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 7, 2012; 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.