Southern Oklahoma Lifestyles and Preventative Medicine

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

SOUTHERN OKLAHOMA LIFESTYLES AND PREVENTATIVE MEDICINE

Doing business as

Paradigm Hormones

Practice address

731 12TH Ave NW Ste 201
Ardmore, OK 73401-5764

Phone

(405) 703-3614

NPI assigned

Nov 17, 2017

Last updated

Nov 17, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

PARADIGM HORMONES, PLLCAs reported in NPPES

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

Authorized official

Name

Nikki Busellato

Title

Ins. Credentialing

Phone

(405) 703-3614

Specialties & licenses 1

Addresses

Other names 1

• Paradigm Hormones Doing business as

Part of

Paradigm Hormones PLLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Paradigm Hormones, PLLC

  • General Practice Physician
  • Moore, OK
  • NPI 1477950764
  NPPES parent name

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1538673256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S I 35 SERVICE RD STE 106",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603187",
            "telephone_number": "405-703-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 12TH AVE NW STE 201",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015764",
            "telephone_number": "405-703-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OKLAHOMA LIFESTYLES AND PREVENTATIVE MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARADIGM HORMONES, PLLC",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "BUSELLATO",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "INS. CREDENTIALING",
        "authorized_official_telephone_number": "405-703-3614"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradigm Hormones",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Okla Surgical Services (Ardmore Regional Surgery Center)
• Southern Oklahoma Ambulance Service, Inc.
• Southern Oklahoma Diagnostic Center, LLC (Open MRI of Southern Oklahoma)
• Southern Oklahoma Ear Nose Throat and Allgery Clinic Inc
• Southern Oklahoma Kidney Center Inc (Abdul N Khan MD)
• Southern Oklahoma Multiple Services Inc P C (Bone & Joint Clinic of Southern Oklahoma)
• Southern Oklahoma Podiatry Services PLLC
• Southern Oklahoma Renal Services, LLC
• Southern Oklahoma Surgical Center Inc
• Southern Oklahoma Surgical Center Inc

• Public Health & General Preventive Medicine Physician in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Public Health & General Preventive Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.