Icp Oklahoma Aco Billing LLC

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

Legal business name

ICP OKLAHOMA ACO BILLING LLC

Practice address

8211 E Regal PL Ste 100
Tulsa, OK 74133-7181

Phone

(855) 498-6767

Fax

(479) 968-1673

NPI assigned

May 12, 2021

Organization subpart

No

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

Authorized official

Name

Ayasha Thomason

Title

Authorized Official

Phone

(501) 831-1168

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Walgreen Co

  • Pharmacy
  • Menomonie, WI
  • NPI 1962417048

  Member Of

  NPD member

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1255915427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "855-498-6767",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 E REGAL PL STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337181",
            "telephone_number": "855-498-6767",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICP OKLAHOMA ACO BILLING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "AYASHA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "501-831-1168"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Ibarra
• Miriam Stephania Ibeh
• Mackenzie Rachelle Ibison
• Austin Iceberg, M.S. -LMFT-CANDIDATE
• Eugene J Ichinose, M.D.
• Id Specialists of Tulsa PC
• Judith Florence Ide, B.A., M.ED.
• Idoc Oklahoma Telehealth Solutions LLC
• Oluwatumilara Idowu, DO
• Mutasim Mohamed Eltigani Idriss, MD

• Clinical Nurse Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Clinical Nurse Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.