Elsie M Lytle

Primary specialty

SpecialistTaxonomy code 174400000X

License

NONE REQUIRED Issued in OK

Practice address

4606 S Garnett Rd
#302
Tulsa, OK 74146-5231

Phone

(918) 664-6544

Fax

(918) 664-0668

NPI assigned

Feb 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Ms. Elsie M Joy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eye Restoration Clinic

  • Prosthetic/Orthotic Supplier
  • Tulsa, OK
  • NPI 1790823300
  NPD (past)

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1447398045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 S GARNETT RD",
            "address_2": "#302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465231",
            "telephone_number": "918-664-6544",
            "fax_number": "918-664-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 S GARNETT RD",
            "address_2": "#302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465231",
            "telephone_number": "918-664-6544",
            "fax_number": "918-664-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTLE",
        "first_name": "ELSIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "NONE REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100810010-A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS MEDICAL ASSOC MCD",
            "identifier": "200302570A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK MEDICAID",
            "identifier": "123441716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "731385829",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "0259450001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICAID",
            "identifier": "323088005",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELSIE",
            "last_name": "JOY",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "B.C.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• George D Lyons, M.D.
• Lauren Paige Buxton Lyons, MA
• Zoe Lyons
• Viacheslav Lysenkov, MD
• Samuel Lytal
• Laila Maaroof, CRNA
• Tabatha Maassen, APRN-CNP
• Maati Ra Counseling Services, PLLC
• Maati Ra Counseling Services, PLLC
• Maati Ra Counseling Services, PLLC.

• Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.