Passport Health of Oklahoma

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

LD2080 Issued in OK

Legal business name

PASSPORT HEALTH OF OKLAHOMA

Practice address

3000 United Founders Blvd
Suite 137
Oklahoma City, OK 73112-3958

Phone

(405) 563-8961

NPI assigned

Aug 19, 2015

Organization subpart

No

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

Authorized official

Name

Emily Sue Hicks, M.S., RDN, LD

Title

Dietitian

Phone

(405) 606-1086

Specialties & licenses 1

Addresses

Practitioners 1

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

• Bret Rice Haymore, MD

  • Allergy & Immunology Physician
  • Broken Arrow, OK
  • NPI 1376503102
  NPD

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1861868259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 UNITED FOUNDERS BLVD",
            "address_2": "SUITE 137",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123958",
            "telephone_number": "405-563-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 UNITED FOUNDERS BLVD",
            "address_2": "SUITE 137",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123958",
            "telephone_number": "405-563-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "405-606-1086",
        "authorized_official_credential": "M.S., RDN, LD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "OK",
            "license": "LD2080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gorge Pasillas, CASE MANAGER
• Emily Paslay, M.S.
• Charles B Pasque, MD
• Ann Marie Passarella, LPN, LPC
• Gabrielle Passmore
• Frances Bernice Pasternik
• Lorrie A. Pastorello
• Delandra R Pate
• James B Pate, MD
• Jennifer Elaina Pate, MOT/L, CLT

• Community Health Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.