Organization Active NPI

Electrodiagnostic Medicine of Tulsa

  • Physical Medicine & Rehabilitation Physician
  • Tulsa, OK
National Provider Identifier
1972750941
Registry record updated Nov 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ELECTRODIAGNOSTIC MEDICINE OF TULSA
Practice address
9308 S Toledo Ave
Tulsa, OK 74137-2739
Phone
(918) 728-8020
Fax
(918) 728-8019
NPI assigned
Aug 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2015

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

Authorized official

Name
Dr. Jeffrey S Halsell, D.O
Title
Provider/Physician
Phone
(918) 728-8020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X

Addresses

Primary practice location

9308 S Toledo Ave
Tulsa, OK 74137-2739

Mailing address

9308 S Toledo Ave
Tulsa, OK 74137-2739
Phone (918) 615-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081113000215 OK Part B Supplier - Clinic/Group Practice 5799845285 Receives reassigned benefits from 1 practitioner
Practice locations: Tulsa, OK
O20100930093534 OK DME Supplier - Physician - Osteopathic Manipulative MedicineDME Supplier - Physician - Physical and Rehabilitation 5799845285 Practice locations: Tulsa, OK

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
37D1106630Electrodiagnostic Medicine9308 S Toledo, Tulsa, OK 74137AccreditationMay 19, 2027

National Provider Directory

National Provider Directory

Locations

421 E 5th St
Bartlesville, OK 74003

801 S Walnut St
Stillwater, OK 74074
Phone (405) 372-2050

9308 S Toledo Ave
Tulsa, OK 74137
Phone (918) 615-6581

Practitioners & affiliated clinicians

Practitioners 1

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": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448064000000",
    "number": "1972750941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9308 S TOLEDO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372739",
            "telephone_number": "918-615-6581",
            "fax_number": "918-893-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9308 S TOLEDO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372739",
            "telephone_number": "918-728-8020",
            "fax_number": "918-728-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELECTRODIAGNOSTIC MEDICINE OF TULSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2015-11-21",
        "status": "A",
        "authorized_official_last_name": "HALSELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROVIDER/PHYSICIAN",
        "authorized_official_telephone_number": "918-728-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.