NPIMap

Organization Active NPI

Sooner Anesthesia Services LLC

  • Anesthesiology Physician
  • Tulsa, OK
National Provider Identifier
1720080401
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOONER ANESTHESIA SERVICES LLC
Practice address
4800 S 109TH E Ave
Tulsa, OK 74146
Phone
(918) 742-2502
Fax
(918) 745-9750
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Dr. Wesley Stotler, D.O.
Title
Medical Director
Phone
(918) 742-2502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4800 S 109TH E Ave
Tulsa, OK 74146

Mailing address

PO Box 470191
Tulsa, OK 74147-0191
Phone (918) 742-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041028000361 OK Part B Supplier - Clinic/Group Practice 7416919899 Receives reassigned benefits from 23 practitioners
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1720080401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470191",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741470191",
            "telephone_number": "918-742-2502",
            "fax_number": "918-745-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S 109TH E AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74146",
            "telephone_number": "918-742-2502",
            "fax_number": "918-745-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER ANESTHESIA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "STOTLER",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "918-742-2502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.