Arkansas Verdigris Valley Health Centers, Inc. | |
505 S Main Porter OK 74454 | |
(918) 483-0111 | |
(918) 483-0112 |
Full Name | Arkansas Verdigris Valley Health Centers, Inc. |
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Speciality | Family Medicine |
Location | 505 S Main, Porter, Oklahoma |
Authorized Official Name and Position | Sonya L Smith (CEO) |
Authorized Official Contact | 9184830111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Arkansas Verdigris Valley Health Centers, Inc. Po Box 334 Porter OK 74454-0334 Ph: (918) 483-0213 | Arkansas Verdigris Valley Health Centers, Inc. 505 S Main Porter OK 74454 Ph: (918) 483-0111 |
NPI Number | 1083740047 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 07/06/2021 |
Medicare PECOS PAC ID | 2961594916 |
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Medicare Enrollment ID | O20070822000520 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083740047 | NPI | - | NPPES |
200109570A | Medicaid | OK |
Provider Name | Ashley N Aldrich |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003850132 PECOS PAC ID: 1153344999 Enrollment ID: I20060118000086 |
Provider Name | Bryan Kent Ledbetter |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194807024 PECOS PAC ID: 5597823716 Enrollment ID: I20081016000447 |
Provider Name | Shelly Carlton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275088254 PECOS PAC ID: 2062778343 Enrollment ID: I20171102003080 |
Provider Name | Jennifer Lyn Stickelmeyer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548730559 PECOS PAC ID: 1052650389 Enrollment ID: I20190305001266 |
Provider Name | Teresa Melinda James |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811529209 PECOS PAC ID: 1850716481 Enrollment ID: I20200730000184 |
Provider Name | Cassandra Brillhart-green |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932776390 PECOS PAC ID: 2062817083 Enrollment ID: I20210828000293 |
Provider Name | Jessica Tara Dixon-neal |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124697511 PECOS PAC ID: 9032557475 Enrollment ID: I20240404002701 |
Provider Name | April D Eavers |
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Provider Type | Practitioner - Other (non-physician) |
Provider Identifiers | NPI Number: 1356922330 PECOS PAC ID: 8123469889 Enrollment ID: I20240513000386 |