Active NPI
Lauren Kimberly Conway, D.O.
- Child Abuse Pediatrics Physician
- Tulsa, OK
National Provider Identifier
1487944104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Abuse Pediatrics Physician
- License
- 5199
- Practice address
- 4444 E 41St St
Tulsa, OK 74135-2527 - Phone
- (918) 619-4400
- Fax
- (918) 619-4322
- NPI assigned
- Apr 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5199 | OK | |
| Child Abuse Pediatrics Physician | 2080C0008X | 5199 | OK | Primary |
Addresses
Primary practice location
4444 E 41St St
Tulsa, OK 74135-2527
Mailing address
2021 E Concord St
Broken Arrow, OK 74012-9637
Phone (918) 636-9390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200462570A | Medicaid | OK |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140825001976 | OK | Practitioner - Pediatric Medicine | 6305064882 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5199 | OK | MD | Child Abuse Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Regents of the University of Oklahoma Ou Physicians Tulsa | Current | Accepting new patients |
Locations
4444 E 41st St
Tulsa, OK 74135
4502 E 41st St
Tulsa, OK 74135
Phone (918) 579-2367
1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600
Interoperability endpoints
- lconway28017@ouhealth.direct-ci.net
- lauren.conway@direct.stjohnhealthsystem.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Tulsa, OK
- NPI 1154385730
OK
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1487944104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 E CONCORD ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740129637",
"telephone_number": "918-636-9390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 E 41ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741352527",
"telephone_number": "918-619-4400",
"fax_number": "918-619-4322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "LAUREN",
"middle_name": "KIMBERLY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-14",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "5199",
"primary": false
},
{
"code": "2080C0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Child Abuse Pediatrics",
"state": "OK",
"license": "5199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200462570A",
"state": "OK"
}
],
"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 Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.