Organization Active NPI

Oklahoma Mobile Lithotripter Associates, L.C.

  • Lithotripsy Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1639618754
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lithotripsy Clinic/CenterTaxonomy code 261QL0400X
Legal business name
OKLAHOMA MOBILE LITHOTRIPTER ASSOCIATES, L.C.
Practice address
5401 N Portland Ave
Suite 640
Oklahoma City, OK 73112-2121
Phone
(405) 604-4160
Fax
(405) 604-4053
NPI assigned
Feb 22, 2017
Organization subpart
Yes
Parent organization
OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Authorized official

Name
Stewart Burchett
Title
Executive Director
Phone
(405) 604-4160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lithotripsy Clinic/Center 261QL0400X Primary

Addresses

Primary practice location

5401 N Portland Ave
Suite 640
Oklahoma City, OK 73112-2121

Mailing address

5401 N Portland Ave
Suite 640
Oklahoma City, OK 73112-2121
Phone (405) 604-4160

National Provider Directory

National Provider Directory
Part of
Oklahoma Lithotripter Associates LC

Locations

5401 N Portland Ave
Ste 640
Oklahoma City, OK 73112
Phone (405) 604-4160

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1639618754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE",
            "address_2": "SUITE 640",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122121",
            "telephone_number": "405-604-4160",
            "fax_number": "405-604-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE",
            "address_2": "SUITE 640",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122121",
            "telephone_number": "405-604-4160",
            "fax_number": "405-604-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA MOBILE LITHOTRIPTER ASSOCIATES, L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "BURCHETT",
        "authorized_official_first_name": "STEWART",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-604-4160"
    },
    "taxonomies": [
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 22, 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.