NPIMap

Organization Active NPI

Green Country Healthcare for Women

  • Specialist
  • Tulsa, OK
National Provider Identifier
1497974984
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
23123 Issued in OK
Legal business name
GREEN COUNTRY HEALTHCARE FOR WOMEN
Practice address
1145 S Utica Ave
500
Tulsa, OK 74104-4000
Phone
(918) 382-5399
Fax
(918) 382-5704
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Conchita Lusalyer Woodruff, M.D.
Title
Owner
Phone
(918) 382-5399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 23123 OK Primary

Addresses

Primary practice location

1145 S Utica Ave
500
Tulsa, OK 74104-4000

Mailing address

1145 S Utica Ave
500
Tulsa, OK 74104-4000
Phone (918) 382-5399

Other identifiers 6

IdentifierTypeStateIssuer
207V00000XOtherOKTAXOMONY
2372057OtherOKPROVIDER NUMBER-UNITED HC
261QM2500XOtherOKTAXONOMY NUMBER
2250926OtherOKUNITED HEALTH CARE
593884499004OtherOKBCBS
1720151707OtherOKNPI -INDIVIUAL

National Provider Directory

National Provider Directory

Locations

205 E Pine St
Ste 150
Tulsa, OK 74106
Phone (918) 382-5399

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497974984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-382-5399",
            "fax_number": "918-382-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-382-5399",
            "fax_number": "918-382-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY HEALTHCARE FOR WOMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "CONCHITA",
        "authorized_official_middle_name": "LUSALYER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-382-5399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "23123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXOMONY",
            "identifier": "207V00000X",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER-UNITED HC",
            "identifier": "2372057",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY NUMBER",
            "identifier": "261QM2500X",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2250926",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "593884499004",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI -INDIVIUAL",
            "identifier": "1720151707",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.