Cradle to College Healthcare, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19827 Issued in OK

Legal business name

CRADLE TO COLLEGE HEALTHCARE, P.C.

Practice address

6565 S Yale Ave
Suite 201
Tulsa, OK 74136-8303

Phone

(918) 494-5170

Fax

(918) 494-5196

NPI assigned

Aug 10, 2005

Organization subpart

No

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

Authorized official

Name

Kelly Renee Harmon, M.D.NPI 1780686709

Title

President

Phone

(918) 494-5170

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Kelly Renee Harmon, M.D.

  • Pediatrics Physician
  • Tulsa, OK
  • NPI 1780686709
  NPD (past) Authorized official

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386646313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "SUITE 201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368303",
            "telephone_number": "918-494-5170",
            "fax_number": "918-494-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "SUITE 201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368303",
            "telephone_number": "918-494-5170",
            "fax_number": "918-494-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRADLE TO COLLEGE HEALTHCARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-494-5170",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "19827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.