Active NPI
Dimo Virostko
- Registered Nurse
- Tulsa, OK
National Provider Identifier
1306389077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0097010
- Practice address
- 1055 S Houston Ave
Tulsa, OK 74127-9043 - Phone
- (918) 921-3200
- Fax
- (918) 560-1399
- NPI assigned
- Nov 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0097010 | OK | Primary |
Addresses
Primary practice location
1055 S Houston Ave
Tulsa, OK 74127-9043
Mailing address
650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 587-9471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0097010 | OK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1306389077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 S PEORIA AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741204429",
"telephone_number": "918-587-9471",
"fax_number": "918-560-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 S HOUSTON AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741279043",
"telephone_number": "918-921-3200",
"fax_number": "918-560-1399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIROSTKO",
"first_name": "DIMO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-29",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "0097010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.