Tulsa Pediatric and Adolescent Medicine, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC

Practice address

1919 S Wheeling Ave
Suite 304
Tulsa, OK 74104-5638

Phone

(918) 748-7620

Fax

(918) 748-7647

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Joel K Gist, M.D.NPI 1770680423

Title

President

Phone

(918) 748-7620

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Joel K Gist, M.D.

  • Pediatric Adolescent Medicine Physician
  • Tulsa, OK
  • NPI 1770680423
  NPD (past) Authorized official
• Donna J Krutka, M.D.

  • Pediatric Adolescent Medicine Physician
  • Tulsa, OK
  • NPI 1033216791
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215975883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "SUITE 304",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7620",
            "fax_number": "918-748-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "SUITE 304",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7620",
            "fax_number": "918-748-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA PEDIATRIC AND ADOLESCENT MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GIST",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-748-7620",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tulsa Orthopaedic Associates Inc.
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• Tulsa Orthopedic Trauma Specialists PC
• Tulsa Otolaryngology Inc.
• Tulsa Pain Consultants, Inc
• Tulsa Pediatric Group, PC
• Tulsa Pediatric Urgent Care
• Tulsa Perinatal Evaluation Center
• Tulsa Plastic Surgery
• Tulsa Precision Dental

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.