Eastern Oklahoma Ear, Nose & Throat Inc

Primary specialty

Sleep Medicine (Otolaryngology) PhysicianTaxonomy code 207YS0012X

Legal business name

EASTERN OKLAHOMA EAR, NOSE & THROAT INC

Practice address

5020 E 68TH St
Tulsa, OK 74136-3307

Phone

(918) 492-3636

Fax

(918) 494-8915

NPI assigned

Apr 18, 2007

Organization subpart

No

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

Authorized official

Name

Susan Weatherly

Title

Credentialing Clerk

Phone

(918) 491-3314

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 25

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

• Mary Michelle Ballard, M.S. CCC-A

  • Audiologist-Hearing Aid Fitter
  • Tulsa, OK
  • NPI 1790298115
  Medicare reassignment Care Compare group NPD
• Brooke Berntson, AUD, CCC-A

  • Audiologist
  • Tulsa, OK
  • NPI 1376213538
  Medicare reassignment Care Compare group NPD
• Benjamin P Brownlee, MD

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1487211256
  Medicare reassignment Care Compare group NPD
• Patrick Cody Buchanan, D.O.

  • Facial Plastic Surgery Physician
  • Tulsa, OK
  • NPI 1578865416
  Medicare reassignment Care Compare group NPD
• Karen Cox, M.S.

  • Audiologist
  • Tulsa, OK
  • NPI 1164602637
  Medicare reassignment Care Compare group NPD
• Brenna Renae Dunlap, AUD

  • Audiologist
  • Tulsa, OK
  • NPI 1659258762
  Medicare reassignment Care Compare group NPD
• Megan D. Ellwood, AUD

  • Audiologist
  • Tulsa, OK
  • NPI 1356898712
  Medicare reassignment Care Compare group NPD
• David William Hall, MD

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1912990201
  Medicare reassignment Care Compare group NPD
• Scott Kerwin Hudson, M.D.

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1639313265
  Medicare reassignment Care Compare group NPD
• Landon Joseph Massoth, M.D.

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1497169734
  Medicare reassignment Care Compare group NPD
• Evan Robert Moore, M.D.

  • Otolaryngology Physician
  • Tulsa, OK
  • NPI 1699982496
  Medicare reassignment Care Compare group NPD
• Molly Pangestu

  • Audiologist
  • Tulsa, OK
  • NPI 1487498275
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1205052149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363307",
            "telephone_number": "918-492-3636",
            "fax_number": "918-494-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363307",
            "telephone_number": "918-492-3636",
            "fax_number": "918-494-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN OKLAHOMA EAR, NOSE & THROAT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "WEATHERLY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING CLERK",
        "authorized_official_telephone_number": "918-491-3314"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100805560B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Oklahoma Center for Women Inc
• Eastern Oklahoma Chiropractic, PLLC
• Eastern Oklahoma Dental Anesthesia Specialists, LLC
• Eastern Oklahoma Dental Institute
• Eastern Oklahoma Ear Nose and Throat Inc
• Eastern Oklahoma Ear, Nose, and Throat
• Eastern Oklahoma Orthopedic Center Inc
• Eastern Oklahoma Surgery Center LLC
• Eastern Oklahoma Wellness Center
• Eastern Oklahoma Wellness Center LLC

• Otolaryngology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Otolaryngology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.