NPIMap

Organization Active NPI

Neurologic Services of Oklahoma LLC

  • Electrodiagnostic Medicine Physician
  • Tulsa, OK
National Provider Identifier
1790722239
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X
Legal business name
NEUROLOGIC SERVICES OF OKLAHOMA LLC
Practice address
2424 E 21St Street
Ste 500
Tulsa, OK 74114-1723
Phone
(918) 743-5552
Fax
(918) 743-5553
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Steve Thomas
Title
Ceo
Phone
(918) 743-5552

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204R00000X Primary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X OK

Addresses

Primary practice location

2424 E 21St Street
Ste 500
Tulsa, OK 74114-1723

Mailing address

PO Box 59001
Dept 4012
Tulsa, OK 74159-9001
Phone (918) 743-5552

Other identifiers 3

IdentifierTypeStateIssuer
611693000OtherDEPT OF LABOR
DE4687OtherRAILROAD MEDICARE
800522442MedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000574 OK Part B Supplier - Clinic/Group Practice 9537104732 Receives reassigned benefits from 7 practitioners
Practice locations: Tulsa, OK

National Provider Directory

National Provider Directory

Locations

5563 S Lewis Ave
Tulsa, OK 74105

2424 E 21st St
Ste 500
Tulsa, OK 74114
Phone (918) 742-0552

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1790722239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59001",
            "address_2": "DEPT 4012",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741599001",
            "telephone_number": "918-743-5552",
            "fax_number": "918-743-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 E 21ST STREET",
            "address_2": "STE 500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141723",
            "telephone_number": "918-743-5552",
            "fax_number": "918-743-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGIC SERVICES OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-743-5552"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "611693000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4687",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800522442",
            "state": "OK"
        }
    ],
    "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 Oct 12, 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.