NPIMap

Organization Active NPI

Clinton J Baird PLC

Doing business as Olympia Neurological Institute

  • Neurological Surgery Physician
  • Tulsa, OK
National Provider Identifier
1376324087
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
CLINTON J BAIRD PLC
Doing business as
Olympia Neurological Institute
Practice address
6130 E 81St St
Tulsa, OK 74137-2125
Phone
(918) 401-1002
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Tyesha Mosquito
Title
Physician Relations Director
Phone
(918) 519-4090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

6130 E 81St St
Tulsa, OK 74137-2125

Mailing address

6130 E 81St St
Tulsa, OK 74137-2125
Phone (918) 401-1002

Other names 1

  • Olympia Neurological Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191118001706 OK DME Supplier - Physician - Neurosurgery 7911242961 Practice locations: Tulsa, OK

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

111 E Old Settlers Blvd
Round Rock, TX 78664
Phone (512) 238-7625

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1376324087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 E 81ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372125",
            "telephone_number": "918-401-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 E 81ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372125",
            "telephone_number": "918-401-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON J BAIRD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "MOSQUITO",
        "authorized_official_first_name": "TYESHA",
        "authorized_official_title_or_position": "PHYSICIAN RELATIONS DIRECTOR",
        "authorized_official_telephone_number": "918-519-4090"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympia Neurological Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 9, 2023; 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.