Individual provider Active NPI

Claire Lukeman Mattocks, D.O.

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1225320328
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5248 Issued in OK
Practice address
2000 S Wheeling Ave
Suite 300
Tulsa, OK 74104-5649
Phone
(918) 906-9414
Fax
(918) 747-3952
NPI assigned
May 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5248 OK Primary

Addresses

Primary practice location

2000 S Wheeling Ave
Suite 300
Tulsa, OK 74104-5649

Mailing address

2000 S Wheeling Ave
Suite 300
Tulsa, OK 74104-5649
Phone (918) 906-9414

Other identifiers 1

IdentifierTypeStateIssuer
200477960AMedicaidOK

Other names 1

  • Claire Elizabeth Lukeman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
St John Medical Center Inc Past Accepting new patients
Pediatric and Adolescent Care, LLP Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1304726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1225320328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045649",
            "telephone_number": "918-906-9414",
            "fax_number": "918-747-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045649",
            "telephone_number": "918-906-9414",
            "fax_number": "918-747-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOCKS",
        "first_name": "CLAIRE",
        "middle_name": "LUKEMAN",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-07",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "5248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200477960A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAIRE",
            "last_name": "LUKEMAN",
            "middle_name": "ELIZABETH",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 9, 2014; 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.