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SOUTH TULSA PEDIATRICS PLLJ
NPI 1215920293
Pediatrics in Tulsa, OK

Active since August 25, 2005CLIA 37D1019199 · Accreditation
7512 E 91ST ST, TULSA, OK 74133(918) 728-2000(917) 728-2000 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About South Tulsa Pediatrics Pllj NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH TULSA PEDIATRICS PLLJ (NPI 1215920293) is a healthcare organization registered as a pediatrics in Tulsa, Oklahoma and active in the NPI registry since August 2005. The organization holds an CLIA Accreditation certificate valid through January 19, 2027 and lists Dawn A Mayberry, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1215920293
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSOUTH TULSA PEDIATRICS PLLJ
Location Address7512 E 91ST STTulsa, OK 74133-6050
Mailing Address7512 E 91st StTulsa, OK 74133-6050 · (918) 728-2000 · Fax (917) 728-2000
Phone(918) 728-2000
Fax(917) 728-2000
Organization SubpartNo
Authorized OfficialDawn A MayberryOwner/physician · (918) 728-2888
Enumeration DateAugust 25, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1215920293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OK · 2732
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
7512 E 91ST ST, Tulsa, OK 74133
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 37D1019199

South Tulsa Pediatrics · Tulsa, OK
Active · expires Jan 19, 2027
CLIA Number37D1019199
Laboratory TypePhysician Office
Certificate Effective DateJanuary 20, 2025
Certificate Expiration DateJanuary 19, 2027
Laboratory DirectorJerry Freed
Laboratory Phone(918) 728-2000
Laboratory LocationSouth Tulsa Pediatrics7512 E 91st Street, Tulsa, OK 74133
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CHRISTINE ELIZABETH NARRIN D.O.
Pediatrics
7512 E 91ST ST
TULSA, OK 74133
Tulsa County (918) 728-2000
JOHN CARROLL KNIPPERS M.DM.
Pediatrics
7512 E 91ST ST
TULSA, OK 74133
Tulsa County (918) 728-2000
MS. DAWN ALENE MAYBERRY D.O.
Pediatrics
7512 E 91ST ST
TULSA, OK 74133
Tulsa County (918) 728-2000
DR. JERRY WAYNE FREED D.O.
Pediatrics
7512 E 91ST ST
TULSA, OK 74133
Tulsa County (918) 728-2000
OSU CENTER FOR HEALTH SCIENCES
Clinic/Center (Medical Specialty)
7512 E 91ST ST
TULSA, OK 74133
Tulsa County (918) 561-8306

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Tulsa Pediatrics Pllj's NPI number?

The NPI number for South Tulsa Pediatrics Pllj is 1215920293. It was assigned to this organization in the NPPES registry on August 25, 2005.

Where is South Tulsa Pediatrics Pllj located?

South Tulsa Pediatrics Pllj is located at 7512 E 91st St, Tulsa, OK 74133. The listed phone number is (918) 728-2000.

What is South Tulsa Pediatrics Pllj's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does South Tulsa Pediatrics Pllj hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 37D1019199) is associated with this NPI, valid through January 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does South Tulsa Pediatrics Pllj accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list South Tulsa Pediatrics Pllj as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Tulsa Pediatrics Pllj was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.