Green Country Emergency Physicians Group of Owasso PLLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

GREEN COUNTRY EMERGENCY PHYSICIANS GROUP OF OWASSO PLLC

Practice address

10502 N 110TH East Ave
Owasso, OK 74055-6655

Phone

(918) 376-8000

Fax

(918) 664-2521

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Jessica Warlick

Title

Credentialing Coordinator

Phone

(918) 664-9892

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1720165830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-664-9892",
            "fax_number": "918-664-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 N 110TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556655",
            "telephone_number": "918-376-8000",
            "fax_number": "918-664-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY EMERGENCY PHYSICIANS GROUP OF OWASSO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "WARLICK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "918-664-9892"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Graffman
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• Matthew Philip Gray, DDS
• Michael Gray
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• Amanda Green
• Anna Marie Green, NP
• Megan Green
• Russell John Green, MD
• Danielle Jeane Gregory, M.S. CCC-SLP

• All providers in Owasso, OK
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.