Individual provider Active NPI

Dawn Unruh, P.A.

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1366544892
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1663 Issued in OK
Practice address
1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041
Phone
(918) 579-5749
Fax
(918) 579-5762
NPI assigned
Sep 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1663 OK Primary

Addresses

Primary practice location

1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041

Mailing address

1145 S Utica Ave Ste 460
Tulsa, OK 74104-4041
Phone (918) 579-5749

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080402000508 OK Practitioner - Physician Assistant 5890786305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001469IAMDMental Health Counselor
521SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Farrell PC Past Accepting new patients
Cardiology Clinic of Muskogee, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3442/brand/1/csg/61/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.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1366544892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 460",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044041",
            "telephone_number": "918-579-5749",
            "fax_number": "918-579-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNRUH",
        "first_name": "DAWN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.