NPIMap

Organization Active NPI

Tulsa Accident Care Center LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Broken Arrow, OK
National Provider Identifier
1245060854
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
TULSA ACCIDENT CARE CENTER LLC
Practice address
1394 E Kenosha St
Broken Arrow, OK 74012
Phone
(918) 888-8080
Fax
(918) 888-8181
NPI assigned
Aug 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Trey Marler
Title
Manager
Phone
(918) 888-8080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

1394 E Kenosha St
Broken Arrow, OK 74012

Mailing address

5705 E 71St St Ste 100
Tulsa, OK 74136-6651
Phone (918) 888-8080

National Provider Directory

National Provider Directory
Tax ID family
Tulsa Accident Care Center LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1245060854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 E 71ST ST STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366651",
            "telephone_number": "918-888-8080",
            "fax_number": "918-888-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-888-8080",
            "fax_number": "918-888-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULSA ACCIDENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "MARLER",
        "authorized_official_first_name": "TREY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-888-8080"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.