Amy Polge

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2653 Issued in OK

Legal business name

AMY POLGE

Doing business as

OU Psychiatry Clinic

Practice address

15007 E 88TH St N
Owasso, OK 74055-4863

Phone

(918) 638-0302

NPI assigned

Nov 10, 2011

Last updated

Nov 28, 2011By 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

Ondria Gleason, MD

Title

Director

Phone

(918) 660-3511

Specialties & licenses 1

Addresses

Other names 1

• OU Psychiatry Clinic Doing business as

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1710264361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15007 E 88TH ST. N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-638-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15007 E 88TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554863",
            "telephone_number": "918-638-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY POLGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "ONDRIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "918-660-3511",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "2653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OU Psychiatry Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Allen, APRN, CNP
• Ryan Elizabeth Allen, PA-C
• Ana Kassandra Alvarez, PTA
• Chelsea Alvarez
• Melissa J Alwert, RN BSN CCM
• Bradley James Anderson, OTR/L
• Stephanie Lee Anderson
• Katherine L Ansboury, RBT
• Apollo Services Inc
• Katelynd Arbaugh

• Community/Behavioral Health Agency in Owasso, OK
• Providers in Owasso, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.