NR South Tulsa LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NR SOUTH TULSA LLC

Doing business as

Nerve Renewal South Tulsa

Practice address

9101 S Toledo Ave Ste a
Tulsa, OK 74137-2719

Phone

(918) 398-0802

Fax

(405) 669-3517

NPI assigned

Jan 8, 2025

Last updated

Mar 3, 2025By 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

Timothy C Bales

Title

Ceo/Owner

Phone

(405) 953-7221

Specialties & licenses 2

Addresses

Other names 1

• Nerve Renewal South Tulsa Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 5

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.

• Damaris Deutsch, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tulsa, OK
  • NPI 1699862573
  Medicare reassignment Care Compare group NPD
• Linda Ellard, APRN

  • Nurse Practitioner
  • Tulsa, OK
  • NPI 1265948269
  Medicare reassignment Care Compare group NPD
• Latrica Friley Dorsey, MSN

  • Gerontology Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1538696083
  Medicare reassignment NPD
• Jennifer Kathleen Hinkle, MD

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
  • NPI 1003057670
  Medicare reassignment NPD
• Ivy Cherian, APRN-CNP

  • Primary Care Nurse Practitioner
  • Yukon, OK
  • NPI 1578296042
  NPD (past)

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1871303313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161937",
            "telephone_number": "405-953-7221",
            "fax_number": "405-669-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 S TOLEDO AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372719",
            "telephone_number": "918-398-0802",
            "fax_number": "405-669-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NR SOUTH TULSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "BALES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "405-953-7221"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nerve Renewal South Tulsa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nerve Renewal South Tulsa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mallory Doris Nowlin, OTR/L
• Ross Nowlin
• Ryan V Nowlin, DDS, MS
• Van L. Nowlin, D.D.S.,M.S.D.
• William Lee Nowlin
• NRF Inc (Couch Long-Term-Care)
• NRF Inc (Couch Pharmacy)
• Ntco LLC (Neuropathy Treatment Center)
• Don Nuam
• Emily Ann Nuckolls, M.S. CEY

• Physical Medicine & Rehabilitation Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.