IV Health Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IV HEALTH CENTER

Practice address

1107 Walnut Dr
Ardmore, OK 73401-2354

Phone

(405) 703-3614

NPI assigned

Feb 16, 2017

Organization subpart

No

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

Authorized official

Name

Nikki Busellato

Title

Credentialing/Contracting

Phone

(405) 703-3614

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1962941427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012354",
            "telephone_number": "405-703-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IV HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "BUSELLATO",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "CREDENTIALING/CONTRACTING",
        "authorized_official_telephone_number": "405-703-3614"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.