NPIMap

Organization Active NPI

Adult Gastroenterology Associates Inc

  • Gastroenterology Physician
  • Tulsa, OK
National Provider Identifier
1306884812
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ADULT GASTROENTEROLOGY ASSOCIATES INC
Practice address
4200 E Skelly Dr Ste 700
Tulsa, OK 74135-3256
Phone
(918) 438-7050
Fax
(918) 221-0835
NPI assigned
Jun 4, 2006
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Dr. Douglas B Kliewer, M.D.NPI 1174518906
Title
Physician
Phone
(918) 481-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

4200 E Skelly Dr Ste 700
Tulsa, OK 74135-3256

Mailing address

PO Box 305
Lowell, AR 72745-0305
Phone (918) 438-7050

Other identifiers 1

IdentifierTypeStateIssuer
100740890AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050919000387 OK Part B Supplier - Clinic/Group Practice 0840223921 Receives reassigned benefits from 20 practitioners
Practice locations: Enid, OK; Muskogee, OK; Tulsa, OK; Bartlesville, OK

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

615 E Oklahoma Ave
Ste 205
Enid, OK 73701
Phone (405) 605-4368

333 S 38th St
Ste H
Muskogee, OK 74401
Phone (918) 681-4291

1560 E 21st St
Ste 150
Tulsa, OK 74114
Phone (918) 438-7050

1725 E 19th St
Ste 600
Tulsa, OK 74104
Phone (918) 748-1330

4200 E Skelly Dr
Tulsa, OK 74135
Phone (918) 438-7050

6465 S Yale Ave
Ste 1002
Tulsa, OK 74136
Phone (918) 481-4700

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1306884812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450305",
            "telephone_number": "918-438-7050",
            "fax_number": "918-221-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E SKELLY DR STE 700",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353256",
            "telephone_number": "918-438-7050",
            "fax_number": "918-221-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT GASTROENTEROLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "KLIEWER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-481-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100740890A",
            "state": "OK"
        }
    ],
    "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 Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.