Active NPI
Reliant Health Providers LLC
- Geriatric Medicine (Internal Medicine) Physician
- Oklahoma City, OK
National Provider Identifier
1548014129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- Legal business name
- RELIANT HEALTH PROVIDERS LLC
- Practice address
- 1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357 - Phone
- (405) 225-1122
- NPI assigned
- Apr 11, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lauren Roche
- Title
- Executive Assistant
- Phone
- (405) 225-1122
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | Primary |
Addresses
Primary practice location
1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Mailing address
1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Phone (405) 225-1122
Other names 1
- Reliant Health Providers
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240520001283 | OK | Part B Supplier - Clinic/Group Practice | 3072955269 |
Receives reassigned benefits from 5 practitioners Practice locations: Oklahoma City, OK |
National Provider Directory
National Provider DirectoryLocations
1601 SW 89th St
Ste A200
Oklahoma City, OK 73159
Phone (405) 225-1122
1601 SW 89th St
Ste A100
Oklahoma City, OK 73159
Phone (405) 225-1122
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712793600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712793600000",
"number": "1548014129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 SW 89TH ST STE A100",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731596357",
"telephone_number": "405-225-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 SW 89TH ST STE A100",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731596357",
"telephone_number": "405-225-1122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RELIANT HEALTH PROVIDERS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-11",
"last_updated": "2024-04-11",
"certification_date": "2024-04-11",
"status": "A",
"authorized_official_last_name": "ROCHE",
"authorized_official_first_name": "LAUREN",
"authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
"authorized_official_telephone_number": "405-225-1122"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Reliant Health Providers",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.