Organization Active NPI

Childrens Clinic of Owasso

  • Pediatrics Physician
  • Owasso, OK
National Provider Identifier
1417166802
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
3442 Issued in OK
Legal business name
CHILDRENS CLINIC OF OWASSO
Practice address
8439 N 117TH East Ave
Owasso, OK 74055-2142
Phone
(918) 272-8989
Fax
(918) 272-4185
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cheryl A Boyd, D,O,NPI 1679501050
Title
Owner
Phone
(918) 272-8989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 3442 OK Primary

Addresses

Primary practice location

8439 N 117TH East Ave
Owasso, OK 74055-2142

Mailing address

8439 N 117TH East Ave
Owasso, OK 74055-2142
Phone (918) 272-8989

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0975974Childrens Clinic of Owasso PC8439 N 117TH E Avenue, Owasso, OK 74055Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory

Locations

8439 N 117th East Ave
Owasso, OK 74055
Phone (918) 272-8989

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417166802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8439 N 117TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552142",
            "telephone_number": "918-272-8989",
            "fax_number": "918-272-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8439 N 117TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552142",
            "telephone_number": "918-272-8989",
            "fax_number": "918-272-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS CLINIC OF OWASSO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-272-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,O,"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "3442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

  • 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.