Tahlequah Orthopedic Surgery Services, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

207X00000X Issued in OK

Legal business name

TAHLEQUAH ORTHOPEDIC SURGERY SERVICES, LLC

Practice address

1373 E. Boone St.
Suite 3401
Tahlequah, OK 74464-3379

Phone

(918) 456-6848

Fax

(918) 456-1150

NPI assigned

Apr 12, 2007

Last updated

Aug 30, 2012By 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

Dr. Christopher Sarrett Deloache, D.O.NPI 1104832179

Title

Owner

Phone

(918) 456-6848

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Christopher S Deloache, D.O.

  • Orthopaedic Surgery Physician
  • Tahlequah, OK
  • NPI 1104832179
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1780808980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 E. BOONE ST.",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643379",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 E. BOONE ST.",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643379",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHLEQUAH ORTHOPEDIC SURGERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "DELOACHE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "SARRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-456-6848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "207X00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200076030A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "448746259004",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tahlequah Family Medicine Clinic
• Tahlequah Family Vision Clinic, PLLC (Tahlequah Family Vision Clinic)
• Tahlequah Internal Medicine Inc
• Tahlequah Medical Associates
• Tahlequah Medical Group LLC
• Tahlequah Public Schools
• Tyler Tait
• Talking Leaves Job Corps
• Jamie Tapp, PHARMD
• Cheryl Delores Tarver, CNM

• Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.