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 | 224ZL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Low Vision | Group - Multi-Specialty |
| No | 152WL0500X | Eye and Vision Services Providers | Optometrist | Low Vision Rehabilitation | 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 | 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 | 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 |
| No | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| OK | 200339810C | Medicaid | |
| OK | 200339810E | Medicaid |