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AVALON PARK PEDIATRICS
NPI 1720204761
Pediatrics in Tulsa, OK

Active since April 18, 2007CLIA 37D1088243 · Waiver
6528 E 101ST ST, SUITE D-1, PMB 419, TULSA, OK 74133(918) 398-7170(918) 398-7199 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Avalon Park Pediatrics NPPES

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

AVALON PARK PEDIATRICS (NPI 1720204761) is a healthcare organization registered as a pediatrics in Tulsa, Oklahoma and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 19, 2026 and lists David Brian Raley, Owner, as its authorized official.

NPPES Registry Identity

NPI1720204761
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameAVALON PARK PEDIATRICS
Location Address6528 E 101ST ST, SUITE D-1, PMB 419Tulsa, OK 74133-6724
Mailing Address7779 East 106th StreetTulsa, OK 74133-6844 · (918) 398-7170 · Fax (918) 398-7199
Phone(918) 398-7170
Fax(918) 398-7199
Organization SubpartNo
Authorized OfficialDavid Brian RaleyOwner · (918) 398-7170
Enumeration DateApril 18, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1720204761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OK · 20582
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.
6528 E 101ST 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

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 Waiver 37D1088243

Avalon Park Pediatrics · Tulsa, OK
Active · expires Aug 19, 2026
CLIA Number37D1088243
Laboratory TypePhysician Office
Certificate Effective DateAugust 20, 2024
Certificate Expiration DateAugust 19, 2026
Laboratory DirectorBrian Raley
Laboratory Phone(918) 398-7170
Laboratory LocationAvalon Park Pediatrics7779 E 106th St, Tulsa, OK 74133
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. JOHN KELLEY GEARHART M.D.
Family Medicine
6528 E 101ST ST, STE I
TULSA, OK 74133
Tulsa County (918) 392-5588
MR. DAVID BRIAN RALEY MD
Pediatrics
6528 E 101ST ST, STE D-1, PMB#419
TULSA, OK 74133
Tulsa County (918) 398-7170
SOUTHCREST MEDICAL GROUP LLC
General Practice
6528 E 101ST ST, STE I
TULSA, OK 74133
Tulsa County (918) 294-4803

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 Avalon Park Pediatrics's NPI number?

The NPI number for Avalon Park Pediatrics is 1720204761. It was assigned to this organization in the NPPES registry on April 18, 2007.

Where is Avalon Park Pediatrics located?

Avalon Park Pediatrics is located at 6528 E 101st St Suite D-1, Pmb 419, Tulsa, OK 74133. The listed phone number is (918) 398-7170.

What is Avalon Park Pediatrics's specialty?

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

Does Avalon Park Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D1088243) is associated with this NPI, valid through August 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avalon Park Pediatrics was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.