Scissortail Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SCISSORTAIL HEALTHCARE LLC

Practice address

4520 S Harvard Ave
Suite 200
Tulsa, OK 74135-2925

Phone

(918) 508-7333

Fax

(918) 551-6113

NPI assigned

Sep 5, 2014

Organization subpart

No

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

Authorized official

Name

Glenn Eddleman

Title

Member

Phone

(918) 508-7333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• VCG Oklahoma LLC

  • Home Health Agency
  • Tulsa, OK
  • NPI 1073212387

  Sold to, 2023-01-31

  CMS change of ownership

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1376944694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 S HARVARD AVE STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352900",
            "telephone_number": "918-508-7333",
            "fax_number": "918-551-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 S HARVARD AVE",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352925",
            "telephone_number": "918-508-7333",
            "fax_number": "918-551-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCISSORTAIL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "EDDLEMAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-508-7333"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ted D Schwendemann
• Carrie Amanda Schwier, ARNP
• Shawn Kristine Schwier, PTA
• Jason C Schwope, MA
• Scissortail Endodontic Specialists
• Scissortail Surgery Center
• Guido Sclabas, MD
• Scott Robison'S Prescriptions
• Scott Robisons RX Inc
• Melissa Lynn Scott-Downer, LPC-US

• Home Health Agency in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Home Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.