Organization Active NPI

Rmo - Tulsa, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Tulsa, OK
National Provider Identifier
1881099414
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
RMO - TULSA, PLLC
Practice address
5522 S Lewis Ave
Tulsa, OK 74105-7105
Phone
(918) 488-8285
NPI assigned
Oct 24, 2014
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Dr. Mark Stephen Wilson, M.D.NPI 1225233604
Title
Ceo, Medical Director
Phone
(918) 488-8285

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU

Addresses

Primary practice location

5522 S Lewis Ave
Tulsa, OK 74105-7105

Mailing address

635 W 79TH St
Tulsa, OK 74132-2645
Phone (918) 488-8285

Other names 1

  • Rehabilitation Medicine of Oklahoma Other name

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
37D2025697Rmo - Tulsa, PLLC5522 South Lewis Avenue, Tulsa, OK 74105Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Locations

5522 S Lewis Ave
Tulsa, OK 74105
Phone (918) 488-8285

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": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1881099414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741322645",
            "telephone_number": "918-488-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5522 S LEWIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741057105",
            "telephone_number": "918-488-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RMO - TULSA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "918-488-8285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehabilitation Medicine of Oklahoma",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.