Active NPI
Tamara Keisha Woleston, M.D.
- Family Medicine Physician
- Tulsa, OK
National Provider Identifier
1972907202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30410
- Practice address
- 1111 S Saint Louis Ave
Tulsa, OK 74120-5440 - Phone
- (918) 619-4600
- NPI assigned
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OK | ||
| Family Medicine Physician | 207Q00000X | 30410 | OK | Primary |
Addresses
Primary practice location
1111 S Saint Louis Ave
Tulsa, OK 74120-5440
Mailing address
1835 E 16TH PL
Tulsa, OK 74104-4923
Phone (973) 330-7832
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30410 | OK | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1972907202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 E 16TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741044923",
"telephone_number": "973-330-7832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 S SAINT LOUIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741205440",
"telephone_number": "918-619-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLESTON",
"first_name": "TAMARA",
"middle_name": "KEISHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-15",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OK",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "30410",
"primary": true
}
],
"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 Apr 3, 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.