Individual provider Active NPI

Ambria Kay Harris, D.O.

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1467744656
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5226 Issued in OK
Practice address
1441 E 75TH PL
Tulsa, OK 74136-7345
Phone
(918) 710-4200
Fax
(918) 295-3155
NPI assigned
May 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5226 OK Primary

Addresses

Primary practice location

1441 E 75TH PL
Tulsa, OK 74136-7345

Mailing address

1441 E 75TH PL
Tulsa, OK 74136-7345
Phone (918) 710-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5226OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Family Medicine CurrentSince Mar 1, 2014 Accepting new patients
St. John Physicians, Inc CurrentSince Mar 1, 2014 Accepting new patients

Locations

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1441 E 75th Pl
Tulsa, OK 74136
Phone (918) 710-4200

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1467744656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 E 75TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367345",
            "telephone_number": "918-710-4200",
            "fax_number": "918-295-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 E 75TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367345",
            "telephone_number": "918-710-4200",
            "fax_number": "918-295-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AMBRIA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.