NPIMap

Organization Active NPI

Team Clinics Ah LLC

  • Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1366022998
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TEAM CLINICS AH LLC
Practice address
3112 Cooke Way
Oklahoma City, OK 73179-2401
Phone
(405) 546-4130
NPI assigned
Apr 8, 2021
Last updated
Apr 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
Trevor Nutt
Title
Ceo
Phone
(405) 546-4130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3112 Cooke Way
Oklahoma City, OK 73179-2401

Mailing address

3112 Cooke Way
Oklahoma City, OK 73179-2401

Other identifiers 1

IdentifierTypeStateIssuer
200782030MedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211025001911 OK Part B Supplier - Clinic/Group Practice 2860880887 Receives reassigned benefits from 4 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory
Tax ID family
Team Clinics Ah LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1366022998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 COOKE WAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731792401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 COOKE WAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731792401",
            "telephone_number": "405-546-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM CLINICS AH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "NUTT",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-546-4130"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200782030",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.