Individual provider Active NPI

Larry Lovelace, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1275511735
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2438 Issued in OK
Practice address
4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone
(918) 728-6145
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2438 OK Primary

Addresses

Primary practice location

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229

Mailing address

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone (918) 728-6145

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000399 OK Practitioner - Emergency MedicinePractitioner - Family Practice 3375597271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmond Urgent Care Inc.Group PAC ID 0547494254, 4 clinicians

Practice addresses (Care Compare)

1101 NW 178TH St
Suite B
Edmond, OK 73012-4281
Phone (405) 285-2161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Urgent Care LLC CurrentSince Sep 4, 2024 Accepting new patients
Oklahoma Treatment Services LLC CurrentSince Apr 1, 2022 Accepting new patients
Lightstar Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Norstar Emergency Physicians Past Accepting new patients
Community Hospital LLC Emergency Medicine Past Accepting new patients

Locations

1101 NW 178th St
#B
Edmond, OK 73012
Phone (405) 285-2161

5401 SW 29th St
Oklahoma City, OK 73179
Phone (405) 681-2003

1613 SE 66th St
Oklahoma City, OK 73149
Phone (405) 612-2361

Organizations & group practices 7

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1275511735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "LARRY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.