Teresa Forehand

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2430 Issued in OK

Practice address

4720 S Harvard Ave
Ste 100
Tulsa, OK 74135-3048

Phone

(918) 749-6370

Fax

(918) 293-3173

NPI assigned

Feb 3, 2015

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

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Susan Chaiser Willard, DO

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1033179916
  Medicare reassignment
• Susan C. Willard, DO, PLLC

  dba Family Health and Wellness Clinic

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1013421023
  NPD (past)

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1679963300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 S HARVARD AVE",
            "address_2": "STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353048",
            "telephone_number": "918-749-6370",
            "fax_number": "918-293-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 S HARVARD AVE",
            "address_2": "STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353048",
            "telephone_number": "918-749-6370",
            "fax_number": "918-293-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREHAND",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Ford
• Stephanie Amber Ford, H.I.S.
• Steven Ford
• William R Ford, M.D.
• Frank Fore, MD
• Aingel Maxine Foreman
• Amy Foreman
• Miranda Gail Foreman
• Nicholas Foreman
• Sandra Scott Foresman, FNP-C, APRN

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.