Cohesive Mediryde

Primary specialty

DriverTaxonomy code 172A00000X

Legal business name

COHESIVE MEDIRYDE

Doing business as

Cohesive Mediryde

Practice address

1616 S State St
Edmond, OK 73013-3600

Phone

(405) 395-4474

NPI assigned

Apr 2, 2019

Last updated

May 24, 2019By 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

Bobby Zeigler

Title

Credentialing Operations

Phone

(918) 902-0460

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cohesive Mediryde Doing business as

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1932661568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E INDEPENDENCE ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 S STATE ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133600",
            "telephone_number": "405-395-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COHESIVE MEDIRYDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "ZEIGLER",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "CREDENTIALING OPERATIONS",
        "authorized_official_telephone_number": "918-902-0460"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200828770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cohesive Mediryde",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cohesive Mediryde",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lawrence J Cohen, PHARMD, BCPP
• Michael Colacicco
• Elaine Marie Cole
• Jeremy Cole, MD
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• Lauren Coleman, PT, DPT

• Driver in Edmond, OK
• Providers in Edmond, OK by specialty
• Driver in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.