Provider Demographics
NPI: | 1871138941 |
---|---|
Name: | NEWVIEW OKLAHOMA INC. |
Entity type: | Organization |
Organization Name: | NEWVIEW OKLAHOMA INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OFFICE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KIERRA |
Authorized Official - Middle Name: | K |
Authorized Official - Last Name: | BROWN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 918-933-4018 |
Mailing Address - Street 1: | 5350 E 31ST ST STE 302 |
Mailing Address - Street 2: | |
Mailing Address - City: | TULSA |
Mailing Address - State: | OK |
Mailing Address - Zip Code: | 74135-5008 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 918-933-4018 |
Mailing Address - Fax: | 918-779-7794 |
Practice Address - Street 1: | 1411 W 12TH AVE STE C |
Practice Address - Street 2: | |
Practice Address - City: | STILLWATER |
Practice Address - State: | OK |
Practice Address - Zip Code: | 74074-5425 |
Practice Address - Country: | US |
Practice Address - Phone: | 918-933-4085 |
Practice Address - Fax: | 918-779-7794 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | NEWVIEW OKLAHOMA INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2019-11-13 |
Last Update Date: | 2019-11-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
No | 152WL0500X | Eye and Vision Services Providers | Optometrist | Low Vision Rehabilitation | Group - Multi-Specialty |
No | 174H00000X | Other Service Providers | Health Educator | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 224ZL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Low Vision | Group - Multi-Specialty |
No | 225CA2400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | Assistive Technology Practitioner | Group - Multi-Specialty |
No | 225CX0006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | Orientation and Mobility Training Provider | Group - Multi-Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OK | 200339810C | Medicaid | |
OK | 200339810E | Medicaid |