NPIMap

Organization Active NPI

Oklahoma State University

  • Primary Care Clinic/Center
  • Tulsa, OK
National Provider Identifier
1235997883
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OKLAHOMA STATE UNIVERSITY
Practice address
5310 E 31St St Ste 1300
Tulsa, OK 74135-5012
Phone
(918) 561-1155
Fax
(918) 561-1218
NPI assigned
Mar 8, 2024
Organization subpart
Yes
Parent organization
OKLAHOMA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Eric John Polak
Title
VP
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5310 E 31St St Ste 1300
Tulsa, OK 74135-5012

Mailing address

5310 E 31St St Ste 1300
Tulsa, OK 74135-5012
Phone (918) 561-1155

Other names 1

  • Oklahoma State University Health Access Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University223 organizations share this tax ID, including this one
Part of
Oklahoma State University

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

Locations

5310 E 31st St
Ste 1300
Tulsa, OK 74135
Phone (918) 561-1155

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1235997883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 1300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355012",
            "telephone_number": "918-561-1155",
            "fax_number": "918-561-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 1300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355012",
            "telephone_number": "918-561-1155",
            "fax_number": "918-561-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OKLAHOMA STATE UNIVERSITY",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oklahoma State University Health Access Network",
            "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 Mar 8, 2024; 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.