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CEDAR RIDGE CLINIC,P.C.
NPI 1366754202
Family Medicine in Tulsa, OK

Active since July 08, 2010CLIA 37D0474802 · Microscopy
10016 S MINGO RD STE A, TULSA, OK 74133(918) 459-0583(918) 250-0120 Get Directions Write a Review

NPPES record last updated: November 23, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cedar Ridge Clinic,p.c. NPPES

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

CEDAR RIDGE CLINIC,P.C. (NPI 1366754202) is a healthcare organization registered as a family medicine in Tulsa, Oklahoma and active in the NPI registry since July 2010. The organization holds a CLIA Microscopy certificate valid through January 28, 2028 and lists Trung H Pham, Physician, as its authorized official.

NPPES Registry Identity

NPI1366754202
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCEDAR RIDGE CLINIC,P.C.
Location Address10016 S MINGO RD STE ATulsa, OK 74133-5789
Mailing Address10016 S Mingo Rd Ste ATulsa, OK 74133-5789 · (918) 459-0583 · Fax (918) 250-0120
Phone(918) 459-0583
Fax(918) 250-0120
Organization SubpartNo
Authorized OfficialTrung H PhamPhysician · (918) 459-0583
Enumeration DateJuly 8, 2010
Last NPPES UpdateNovember 23, 2010
✔ NPI 1366754202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 3313
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
10016 S MINGO RD STE A, Tulsa, OK 74133
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Other Identifiers 3

Medicare PIN586468911TOK
Medicaid100223040FOK
Medicare UPING31474OK

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

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 for Provider-Performed Microscopy Procedures (PPMP) 37D0474802

Cedar Ridge Family Clinic · Tulsa, OK
Active · expires Jan 28, 2028
CLIA Number37D0474802
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2026
Certificate Expiration DateJanuary 28, 2028
Laboratory DirectorTrung Pham
Laboratory Phone(918) 459-0583
Laboratory LocationCedar Ridge Family Clinic10016-A South Mingo Road, Tulsa, OK 74133
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

TRUNG H PHAM D.O.
Family Medicine
10016 S MINGO RD STE A
TULSA, OK 74133
Tulsa County (918) 459-0583

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 Cedar Ridge Clinic,p.C.'s NPI number?

The NPI number for Cedar Ridge Clinic,p.C. is 1366754202. It was assigned to this organization in the NPPES registry on July 8, 2010.

Where is Cedar Ridge Clinic,p.C. located?

Cedar Ridge Clinic,p.C. is located at 10016 S Mingo Rd Ste A, Tulsa, OK 74133. The listed phone number is (918) 459-0583.

What is Cedar Ridge Clinic,p.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Cedar Ridge Clinic,p.C. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 37D0474802) is associated with this NPI, valid through January 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cedar Ridge Clinic,p.C. was last updated on November 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.