GLORYLAND HEALTHCARE SERVICES, LLC
NPI 1811452907
Clinic/Center - Primary Care in Tulsa, OK

Q: What is Gloryland Healthcare Services, LLC's NPI number?

The NPI number for Gloryland Healthcare Services, LLC is 1811452907. It was assigned to this organization in the NPPES registry on February 4, 2019.

Q: What is Gloryland Healthcare Services, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since February 04, 2019

1312 S GARNETT RD, TULSA, OK 74128(918) 203-3164(918) 203-3163 Get Directions Write a Review

NPPES record last updated: February 4, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Gloryland Healthcare Services, Llc NPPES

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

GLORYLAND HEALTHCARE SERVICES, LLC (NPI 1811452907) is a healthcare organization registered as a primary care in Tulsa, Oklahoma and active in the NPI registry since February 2019. The organization lists Augustina Agadagba, Owner, as its authorized official.

NPPES Registry Identity

NPI1811452907

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameGLORYLAND HEALTHCARE SERVICES, LLC

Location Address1312 S GARNETT RDTulsa, OK 74128-1811

Mailing Address909 S Aster AveBroken Arrow, OK 74012-8832 · (918) 813-0511

Phone(918) 203-3164

Fax(918) 203-3163

Organization SubpartNo

Authorized OfficialAugustina AgadagbaOwner · (918) 813-0511

Enumeration DateFebruary 4, 2019

✔ NPI 1811452907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

1312 S GARNETT RD, Tulsa, OK 74128

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Other Identifiers 1

Medicaid200498000AOK

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gloryland Healthcare Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gloryland Healthcare Services, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Augustina Agadagba, CNP

Nurse Practitioner

NPI 1205179561

350 S 40TH ST
Muskogee, OK 74401

(918) 683-0753

✔ PECOS✔ Accepts Medicare37 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Gloryland Healthcare Services, LLC's NPI number?

The NPI number for Gloryland Healthcare Services, LLC is 1811452907. It was assigned to this organization in the NPPES registry on February 4, 2019.

Where is Gloryland Healthcare Services, LLC located?

Gloryland Healthcare Services, LLC is located at 1312 S Garnett Rd, Tulsa, OK 74128. The listed phone number is (918) 203-3164.

What is Gloryland Healthcare Services, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Gloryland Healthcare Services, LLC enrolled in Medicare?

Yes. Gloryland Healthcare Services, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gloryland Healthcare Services, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Gloryland Healthcare Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gloryland Healthcare Services, LLC was last updated on February 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.