Individual provider Active NPI

Lauren Kimberly Conway, D.O.

  • Child Abuse Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1487944104
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
5199 Issued in OK
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

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200462570AMedicaidOK

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
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

LicenseStateTypeSpecialty
5199OKMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Jul 1, 2014 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

  • Direct secure messaging: lconway28017@ouhealth.direct-ci.net
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.