NPIMap

Organization Active NPI

Catoosa Hope Clinic PLLC

Doing business as Catoosa Hope Clinic

  • Psychiatry Physician
  • Catoosa, OK
National Provider Identifier
1568753101
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CATOOSA HOPE CLINIC PLLC
Doing business as
Catoosa Hope Clinic
Practice address
1755 N Highway 66
Ste F
Catoosa, OK 74015-2409
Phone
(918) 739-4885
Fax
(918) 739-4885
NPI assigned
May 1, 2011
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Dr. Kyla Lussier, M.D.NPI 1205033446
Title
Physician
Phone
(918) 739-4885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OK Primary

Addresses

Primary practice location

1755 N Highway 66
Ste F
Catoosa, OK 74015-2409

Mailing address

1755 N Highway 66
Ste F
Catoosa, OK 74015-2409
Phone (918) 739-4885

Other identifiers 1

IdentifierTypeStateIssuer
200339530AMedicaidOK

Other names 1

  • Catoosa Hope Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

5525 E 51st St
Ste 310
Tulsa, OK 74135
Phone (918) 200-1742

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1568753101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 N HIGHWAY 66",
            "address_2": "STE F",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740152409",
            "telephone_number": "918-739-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N HIGHWAY 66",
            "address_2": "STE F",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740152409",
            "telephone_number": "918-739-4885",
            "fax_number": "918-739-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATOOSA HOPE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-01",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "LUSSIER",
        "authorized_official_first_name": "KYLA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-739-4885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200339530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catoosa Hope Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Catoosa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.