Team Clinics Ancillary Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TEAM CLINICS ANCILLARY SERVICES LLC

Practice address

3112 Cooke Way
Oklahoma City, OK 73179-2401

Phone

(405) 546-4130

NPI assigned

Apr 8, 2021

Last updated

Oct 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trevor Nutt

Title

Ceo

Phone

(405) 546-4130

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1649850280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ROBERT S KERR AVE STE 1600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731024216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 COOKE WAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731792401",
            "telephone_number": "405-546-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 N Union Ave",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748042966",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 E Independence St",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748044225",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 N Union Ave",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748017053",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 N Louisa Ave",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748015832",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 N Draper Ave",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748017410",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1831 Airport Dr",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748042640",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 N Kennedy Ave",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748014730",
            "country_code": "US",
            "telephone_number": "405-546-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEAM CLINICS ANCILLARY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "NUTT",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-546-4130"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201104850A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David C Teague, MD
• Emily Teal
• Team Clinics Ah LLC
• Team Clinics Ah LLC
• Team Clinics Ah LLC
• Team Medical, Inc. (The Brace Place)
• Jacquelyn N Tecmire
• Ted Jeffers
• Jonathan Daniel Tedder
• Jerry R Teel, PHD

• Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.