NPIMap

Organization Active NPI

Archwell Health Professional Services of Oklahoma, LLC

  • Internal Medicine Physician
  • Tulsa, OK
National Provider Identifier
1457934895
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ARCHWELL HEALTH PROFESSIONAL SERVICES OF OKLAHOMA, LLC
Practice address
3138 S Garnett Rd
Tulsa, OK 74146-1933
Phone
(888) 987-1151
NPI assigned
May 3, 2021
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Lisa Lucas
Title
Chief Administrative Officer
Phone
(615) 419-9047

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

3138 S Garnett Rd
Tulsa, OK 74146-1933

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250

Other practice location 1

7317 S Western Ave
Oklahoma City, OK 73139-2007
Phone (888) 987-1151

Other practice location 2

4605 NW 23rd St
Oklahoma City, OK 73127-2128
Phone (888) 987-1151

Other practice location 3

6951 SE 15th St
Midwest City, OK 73110-2748
Phone (888) 987-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210831000931 OK Part B Supplier - Clinic/Group Practice 6608272638 Receives reassigned benefits from 43 practitioners
Practice locations: Midwest City, OK; Oklahoma City, OK; Tulsa, OK

National Provider Directory

National Provider Directory

Locations

6915 SE 15TH St
Archwell Health Middel
Midwest City, OK 73110
Phone (405) 233-0450

4629 NW 23rd St
Oklahoma City, OK 73127
Phone (405) 251-8880

7313 S Western Ave
Oklahoma City, OK 73139
Phone (405) 251-8884

2235 E 61st St
Ste B
Tulsa, OK 74136
Phone (539) 476-9802

3138 S Garnett Rd
Tulsa, OK 74146
Phone (918) 203-7005

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1457934895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 S GARNETT RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741461933",
            "telephone_number": "888-987-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7317 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731392007",
            "country_code": "US",
            "telephone_number": "888-987-1151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4605 NW 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731272128",
            "country_code": "US",
            "telephone_number": "888-987-1151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6951 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731102748",
            "country_code": "US",
            "telephone_number": "888-987-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARCHWELL HEALTH PROFESSIONAL SERVICES OF OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "615-419-9047"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.