Organization Active NPI

Gtoddmed PLLC

  • Primary Care Clinic/Center
  • Tulsa, OK
National Provider Identifier
1770294209
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GTODDMED PLLC
Practice address
1819 E 19TH St Ste 302
Tulsa, OK 74104-5414
Phone
(918) 742-0552
NPI assigned
Dec 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Sherita Barrett
Title
Credentialing Coordinator
Phone
(405) 600-6869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1819 E 19TH St Ste 302
Tulsa, OK 74104-5414

Mailing address

1819 E 19TH St Ste 302
Tulsa, OK 74104-5414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230302000362 OK Part B Supplier - Clinic/Group Practice 0749653368 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

1819 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 742-0552

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1770294209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045414",
            "telephone_number": "918-742-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GTODDMED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "SHERITA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "405-600-6869"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Dec 6, 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.