NPIMap

Organization Active NPI

Board of Regents of the University of Oklahoma Ou Physicians Tulsa

Doing business as OU Physicians Tulsa Wayman Tisdale Clinic

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1194844936
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA
Doing business as
OU Physicians Tulsa Wayman Tisdale Clinic
Practice address
591 E 36TH St N
Tulsa, OK 74106-1812
Phone
(918) 619-8700
Fax
(918) 634-7884
NPI assigned
Mar 29, 2007
Last updated
Jul 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Jonathan Joiner
Title
Coo Ou Physicians Tulsa
Phone
(918) 660-3081

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X Primary
Neurology Physician 2084N0400X

Addresses

Primary practice location

591 E 36TH St N
Tulsa, OK 74106-1812

Mailing address

4502 E 41St St # 2G08
Ou Physicians Tulsa-Clinical Services
Tulsa, OK 74135-2536
Phone (918) 660-3632

Other identifiers 1

IdentifierTypeStateIssuer
100745000UMedicaidOK

Other names 1

  • OU Physicians Tulsa Wayman Tisdale Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2064291Wayman Tisdale Specialty Health Clinic Ou - Tulsa591 E 36TH St North, Tulsa, OK 74106Certificate of waiverAug 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Board of Regents of the University of Oklahoma53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1194844936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 E 41ST ST # 2G08",
            "address_2": "OU PHYSICIANS TULSA-CLINICAL SERVICES",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352536",
            "telephone_number": "918-660-3632",
            "fax_number": "918-660-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 E 36TH ST N",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741061812",
            "telephone_number": "918-619-8700",
            "fax_number": "918-634-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA OU PHYSICIANS TULSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "JOINER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "COO OU PHYSICIANS TULSA",
        "authorized_official_telephone_number": "918-660-3081"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100745000U",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OU Physicians Tulsa Wayman Tisdale Clinic",
            "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 Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.