NPIMap

Organization Active NPI

Team Clinics Ah LLC

  • Clinic/Center
  • Shawnee, OK
National Provider Identifier
1790564136
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TEAM CLINICS AH LLC
Practice address
42400 Garretts Lake Rd
Shawnee, OK 74804-9301
Phone
(405) 275-3473
NPI assigned
Sep 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Trevor Allen Nutt
Title
Ceo
Phone
(405) 540-4130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

42400 Garretts Lake Rd
Shawnee, OK 74804-9301

Mailing address

3112 Cooke Way
Oklahoma City, OK 73179-2401
Phone (405) 546-4130

Other identifiers 1

IdentifierTypeStateIssuer
200920640MedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Team Clinics Ah LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1790564136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 COOKE WAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731792401",
            "telephone_number": "405-546-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42400 GARRETTS LAKE RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049301",
            "telephone_number": "405-275-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM CLINICS AH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "NUTT",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-540-4130"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200920640",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.