NPIMap

Organization Active NPI

Metro Tulsa Foot & Ankle Specialist PLLC

  • Primary Podiatric Medicine Podiatrist
  • Tulsa, OK
National Provider Identifier
1720467483
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
154 Issued in OK
Legal business name
METRO TULSA FOOT & ANKLE SPECIALIST PLLC
Doing business as
Metro Tulsa Foot & Ankle Specialist PLLC
Practice address
3627 S Harvard Ave
Tulsa, OK 74135-2227
Phone
(918) 494-2902
Fax
(918) 494-2905
NPI assigned
May 27, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Dana Jo Jamison
Title
Office Manager
Phone
(918) 494-2902

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 154 OK
Primary Podiatric Medicine Podiatrist 213EP1101X 154 OK Primary

Addresses

Primary practice location

3627 S Harvard Ave
Tulsa, OK 74135-2227

Mailing address

3627 S Harvard Ave
Tulsa, OK 74135-2227
Phone (918) 477-4855

Other identifiers 4

IdentifierTypeStateIssuer
1168810005OtherOKDME PTAN
1168810005OtherOKNSC
1720467483OtherOKDME NPI
731510850OtherOKTAX ID

Other names 1

  • Metro Tulsa Foot & Ankle Specialist PLLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151022000956 OK DME Supplier - Physician - Podiatry 1759293046 Practice locations: Tulsa, OK

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Metro Tulsa Foot Ankle5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

421 W Washington St
Broken Arrow, OK 74012
Phone (918) 455-2001

10229 E 96th St N
Ste 100
Owasso, OK 74055
Phone (918) 272-8920

11215 N Garnett Rd
Ste C
Owasso, OK 74055
Phone (918) 371-7719

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1720467483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352227",
            "telephone_number": "918-477-4855",
            "fax_number": "918-301-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352227",
            "telephone_number": "918-494-2902",
            "fax_number": "918-494-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO TULSA FOOT & ANKLE SPECIALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-494-2902",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": "154",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OK",
            "license": "154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "1168810005",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "1168810005",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME NPI",
            "identifier": "1720467483",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "731510850",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Tulsa Foot & Ankle Specialist PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.