| Shoolin Llc | |
|
105 S Bryant Ave Ste 101 Edmond OK 73034-6330 | |
| (405) 861-0004 | |
| (855) 680-8890 |
| Full Name | Shoolin Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 105 S Bryant Ave Ste 101, Edmond, Oklahoma |
| Authorized Official Name and Position | Rakesh Shrivastava (OWNER) |
| Authorized Official Contact | 4056428613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoolin Llc Po Box 8350 Edmond OK 73083-8350 Ph: (405) 861-0004 | Shoolin Llc 105 S Bryant Ave Ste 101 Edmond OK 73034-6330 Ph: (405) 861-0004 |
| NPI Number | 1972012722 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 02/16/2022 |
| Medicare PECOS PAC ID | 0840566881 |
|---|---|
| Medicare Enrollment ID | O20171019000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972012722 | NPI | - | NPPES |
| Provider Name | Lakshminarayanan Ramakrishnan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578526109 PECOS PAC ID: 1557338274 Enrollment ID: I20041118000236 |
| Provider Name | Rakesh Shrivastava |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043250863 PECOS PAC ID: 2466354063 Enrollment ID: I20100923000332 |
| Provider Name | Akshey Bhanot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437189198 PECOS PAC ID: 1658397351 Enrollment ID: I20110615000479 |
| Provider Name | Monica Tubbesing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063876985 PECOS PAC ID: 0446532428 Enrollment ID: I20170127000397 |
| Provider Name | Rama Krishna Reddy Chanda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710261961 PECOS PAC ID: 6305078288 Enrollment ID: I20180611001637 |
| Provider Name | Sarah Elise Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104355114 PECOS PAC ID: 6709156466 Enrollment ID: I20190626003247 |
| Provider Name | Larry Sharp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306903315 PECOS PAC ID: 3476694217 Enrollment ID: I20190708002113 |
| Provider Name | Sidney Le |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356795660 PECOS PAC ID: 6406137231 Enrollment ID: I20190729000187 |
| Provider Name | Kristie Michelle Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356995476 PECOS PAC ID: 8921431610 Enrollment ID: I20191211001118 |
| Provider Name | Jessica Susan Culpepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033766167 PECOS PAC ID: 3870926363 Enrollment ID: I20191216000559 |
| Provider Name | Lauren D'ann Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821627167 PECOS PAC ID: 2668895178 Enrollment ID: I20200630003044 |
| Provider Name | Christopher Daniel Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831712215 PECOS PAC ID: 5294108874 Enrollment ID: I20230301001565 |
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