Organization Active NPI

Magnolia Health PLLC

  • Women's Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1619643483
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Legal business name
MAGNOLIA HEALTH PLLC
Practice address
1919 S Wheeling Ave Ste 300
Tulsa, OK 74104-5632
Phone
(918) 794-0701
NPI assigned
Aug 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Brooke Golwas, APRN-CNPNPI 1689983553
Title
Owner & Operator
Phone
(918) 794-0701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X Primary

Addresses

Primary practice location

1919 S Wheeling Ave Ste 300
Tulsa, OK 74104-5632

Mailing address

1919 S Wheeling Ave Ste 300
Tulsa, OK 74104-5632
Phone (918) 794-0701

Other names 1

  • Magnolia Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210911000079 OK Part B Supplier - Clinic/Group Practice 2961808217 Receives reassigned benefits from 2 practitioners
Practice locations: Tulsa, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2236308Magnolia Health1919 S Wheeling Ave, Ste 300, Tulsa, OK 74104Certificate of waiverSep 15, 2027

National Provider Directory

National Provider Directory

Locations

2906 Ocoee St N
Cleveland, TN 37312
Phone (423) 790-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24705/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1619643483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045632",
            "telephone_number": "918-794-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045632",
            "telephone_number": "918-794-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "GOLWAS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER & OPERATOR",
        "authorized_official_telephone_number": "918-794-0701",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.