Individual provider Active NPI

Lori Jessica Whelan, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tulsa, OK
National Provider Identifier
1487611919
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
23535 Issued in OK
Practice address
6161 S Yale Ave
ER Dept
Tulsa, OK 74136-1902
Phone
(918) 494-1817
Fax
(405) 749-4561
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 23535 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
ER Dept
Tulsa, OK 74136-1902

Mailing address

PO Box 22063
Dept 0491
Tulsa, OK 74121-2063
Phone (405) 751-4664

Other identifiers 2

IdentifierTypeStateIssuer
200013790AMedicaidOK
P00121899OtherOKRR MEDICARE

Other names 1

  • Lori Jessica Wylie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040122000891 OK Practitioner - Emergency Medicine 9032011853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.83 of 100Reported as group
Quality
81.24
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23535OKMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Jul 1, 2010 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Past Accepting new patients
Emergency Management Associates PC Past Accepting new patients
Emergency Medicine Association of Pittsburgh Past Accepting new patients
Brian Kent MD Inc PC Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

10502 N 110th East Ave
Owasso, OK 74055
Phone (918) 376-8000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Organizations & group practices 6

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1487611919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22063",
            "address_2": "DEPT 0491",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741212063",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "address_2": "ER DEPT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-1817",
            "fax_number": "405-749-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHELAN",
        "first_name": "LORI",
        "middle_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "23535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200013790A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00121899",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "WYLIE",
            "middle_name": "JESSICA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.