Active NPI
Tulsa Podiatry Clinics LLC
- Podiatrist
- Edmond, OK
National Provider Identifier
1619475696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- TULSA PODIATRY CLINICS LLC
- Practice address
- 416 W 15TH St Ste 500C
Edmond, OK 73013-3672 - Phone
- (405) 471-6190
- Fax
- (405) 285-8900
- NPI assigned
- Jan 25, 2018
- 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
- Mr. Chad E Huffmyer
- Title
- Ceo
- Phone
- (405) 816-6266
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
416 W 15TH St Ste 500C
Edmond, OK 73013-3672
Mailing address
PO Box 5231
Edmond, OK 73083-5231
Phone (405) 816-6266
Other names 1
- HealthMark Physicians Network LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180420000161 | OK | Part B Supplier - Clinic/Group Practice | 5395008601 |
Receives reassigned benefits from 2 practitioners Practice locations: Edmond, OK |
National Provider Directory
National Provider DirectoryLocations
2300 S Broadway
Ste 110
Edmond, OK 73013
Phone (405) 209-0322
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Owasso, OK
- NPI 1710154471
-
- Podiatrist
- Lawton, OK
- NPI 1336284595
-
- Podiatrist
- Enid, OK
- NPI 1407831951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1516838400000",
"number": "1619475696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5231",
"city": "EDMOND",
"state": "OK",
"postal_code": "730835231",
"telephone_number": "405-816-6266",
"fax_number": "405-285-8921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 W 15TH ST STE 500C",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133672",
"telephone_number": "405-471-6190",
"fax_number": "405-285-8900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TULSA PODIATRY CLINICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-25",
"last_updated": "2018-01-25",
"status": "A",
"authorized_official_last_name": "HUFFMYER",
"authorized_official_first_name": "CHAD",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "405-816-6266",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "HealthMark Physicians Network LLC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.