Individual provider Active NPI

Courtney Sauls, D.O.

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1538522875
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6249 Issued in OK
Practice address
717 S Houston Ave
4TH Floor
Tulsa, OK 74127-9023
Phone
(918) 382-3100
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 6249 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

717 S Houston Ave
4TH Floor
Tulsa, OK 74127-9023

Mailing address

1919 S Wheeling Ave
Ste 304
Tulsa, OK 74104-5632
Phone (918) 794-7337

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
I20191014000753 OK Practitioner - Pediatric Medicine 8022349638 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6249OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc Single Specialty CurrentSince Oct 28, 2019 Accepting new patients
St. John Physicians, Inc. Single Specialty CurrentSince Sep 29, 2019 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Oklahoma State University Pediatrics Past Accepting new patients

Locations

1919 S Wheeling Ave
Ste 304
Tulsa, OK 74104
Phone (918) 748-7620

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

Organizations & group practices 4

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1538522875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 304",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045632",
            "telephone_number": "918-794-7337",
            "fax_number": "918-403-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE",
            "address_2": "4TH FLOOR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279023",
            "telephone_number": "918-382-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULS",
        "first_name": "COURTNEY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6249",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.