Diana L Defelice, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2160 Issued in OK

Practice address

13616 E 103Rd St N
Ste a
Owasso, OK 74055-4586

Phone

(918) 274-8555

Fax

(918) 274-8556

NPI assigned

Aug 19, 2005

Last updated

Oct 6, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St John Urgent Care Clinics Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1003918830
  Medicare reassignment NPD
• Claremore Physicians LLC

  • Clinic/Center
  • Claremore, OK
  • NPI 1982692216
  NPD (past)
• Cleveland Area Hospital Authority

  dba Lake Area Medical Associates

  • General Practice Physician
  • Cleveland, OK
  • NPI 1174774855
  NPD (past)
• Morton Comprehensive Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
  • NPI 1457166522

  Family Medicine

  NPD (past)
• Urgent Care of Green Country PLLC

  • Urgent Care Clinic/Center
  • Claremore, OK
  • NPI 1336293067
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1649262270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717S UTICA AVE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "918-748-1300",
            "fax_number": "918-748-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13616 E 103RD ST N",
            "address_2": "STE A",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554586",
            "telephone_number": "918-274-8555",
            "fax_number": "918-274-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "DIANA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SONICARE MEDICAID",
            "identifier": "100768880I",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088200B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylyn Nicole Davis, M.S., LPC, NCC
• Natalee Davis
• Chloe Lynn Riley Dawson
• Joseph W Day, DMD
• Timothy Dearhamer
• Clayton David Dejarnett, D.O.
• Deborah Jean Dejarnett, DO
• Victoria Delaney, APRN
• Denise Johnson, OD,PLLC
• April Breanne Denney, PHARM.D

• Family Medicine Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.

Verify at the official NPI Registry.