NPIMap

Organization Active NPI

Camelot Cancer Care Inc

  • Clinic/Center
  • Tulsa, OK
National Provider Identifier
1396012407
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
18381 Issued in OK
Legal business name
CAMELOT CANCER CARE INC
Practice address
6804 S Canton Ave
Suite 110
Tulsa, OK 74136-3423
Phone
(918) 493-1011
Fax
(918) 493-1011
NPI assigned
Nov 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Authorized official

Name
Dr. Lynn Karin Jennings, M.D.
Title
Medical Director
Phone
(918) 493-1011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 18381 OK Primary

Addresses

Primary practice location

6804 S Canton Ave
Suite 110
Tulsa, OK 74136-3423

Mailing address

6804 S Canton Ave
Suite 110
Tulsa, OK 74136-3423
Phone (918) 493-1011

Other identifiers 1

IdentifierTypeStateIssuer
18381OtherOKSTATE OF OKLAHOMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1396012407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 S CANTON AVE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363423",
            "telephone_number": "918-493-1011",
            "fax_number": "918-493-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 S CANTON AVE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363423",
            "telephone_number": "918-493-1011",
            "fax_number": "918-493-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT CANCER CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "KARIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "918-493-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "18381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OKLAHOMA",
            "identifier": "18381",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 18, 2011; 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.