Organization Active NPI

Elevation Health LLC

  • Clinic/Center
  • Edmond, OK
National Provider Identifier
1841077807
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ELEVATION HEALTH LLC
Practice address
1745 W 33Rd St
Edmond, OK 73013-3831
Phone
(406) 309-4780
NPI assigned
Sep 13, 2023
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Charles Tate Woodward, DONPI 1760606917
Title
Physician/Owner
Phone
(406) 309-4780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1745 W 33Rd St
Edmond, OK 73013-3831

Mailing address

1745 W 33Rd St
Edmond, OK 73013-3831
Phone (406) 309-4780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240222000163 OK Part B Supplier - Clinic/Group Practice 4486098019 Receives reassigned benefits from 2 practitioners
Practice locations: Edmond, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2309134Elevation Health1745 W 33Rd St, Edmond, OK 73013Certificate of waiverAug 8, 2026

National Provider Directory

National Provider Directory

Locations

1745 W 33rd St
Edmond, OK 73013
Phone (405) 826-2256

Practitioners & affiliated clinicians

Practitioners 2

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": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1841077807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133831",
            "telephone_number": "406-309-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133831",
            "telephone_number": "406-309-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATION HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "WOODWARD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "TATE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "406-309-4780",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.