New Life Medical Center

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

NEW LIFE MEDICAL CENTER

Practice address

5018 E 68TH St
Tulsa, OK 74136

Phone

(918) 932-2057

Fax

(918) 932-2058

NPI assigned

Feb 5, 2016

Last updated

Feb 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matthew D Adcock

Title

VP

Phone

(918) 932-2057

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1386002327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5018 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363367",
            "telephone_number": "918-932-2057",
            "fax_number": "918-932-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5018 E 68TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-932-2057",
            "fax_number": "918-932-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "918-932-2057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28118170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.