Active NPI
Lara Madison Holder, NP
- Nurse Practitioner
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 103047
- Practice address
- 1265 S Utica Ave
Tulsa, OK 74104-4243 - Phone
- (918) 592-0999
- Fax
- (918) 592-1021
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R103047 | OK | |
| Nurse Practitioner | 363L00000X | 103047 | OK | Primary |
Addresses
Primary practice location
1265 S Utica Ave
Tulsa, OK 74104-4243
Mailing address
1265 S Utica Ave Ste 105
Tulsa, OK 74104-4243
Phone (918) 592-0999
Other names 1
- Lara Madison Long
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243
Phone (918) 592-0999
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R103047 | OK | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Oklahoma Heart LLC | Current | Accepting new patients | |
| Oklahoma Heart Inc | Past | Accepting new patients | |
| Integris Cardiovascular Physicians LLC | Past | Accepting new patients |
Locations
Dept 1218
Tulsa, OK 74182
1265 S Utica Ave
Ste 105
Tulsa, OK 74104
Phone (918) 584-2500
1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 855-2570
9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820
Interoperability endpoints
- llong108600@ahs.direct-ci.com
- https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Oklahoma City, OK
- NPI 1306129598
-
- Specialist
- Tulsa, OK
- NPI 1972574044
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hillcrest Hospital Claremore
- General Acute Care Hospital
- Claremore, OK
- NPI 1023398807
-
dba Hillcrest Medical Center
- General Acute Care Hospital
- Tulsa, OK
- NPI 1629057229
-
dba Hillcrest Hospital Pryor
- General Acute Care Hospital
- Pryor, OK
- NPI 1780125005
-
dba HIllcrest Hospital South
- General Acute Care Hospital
- Tulsa, OK
- NPI 1750661534
-
- General Acute Care Hospital
- Tahlequah, OK
- NPI 1275799645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1265910269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1265 S UTICA AVE STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741044243",
"telephone_number": "918-592-0999",
"fax_number": "918-592-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 S UTICA AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741044243",
"telephone_number": "918-592-0999",
"fax_number": "918-592-1021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "LARA",
"middle_name": "MADISON",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-01",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "R103047",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "103047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LARA",
"last_name": "LONG",
"middle_name": "MADISON",
"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 Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.