| Achieve Health Family Medicine Pllc | |
|
12401 N May Ave Ste 102 Oklahoma City OK 73120-1967 | |
| (405) 631-0483 | |
| Not Available |
| Full Name | Achieve Health Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 12401 N May Ave Ste 102, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Ryan D Wilson (CMO) |
| Authorized Official Contact | 4056310483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Achieve Health Family Medicine Pllc 12401 N May Ave Ste 102 Oklahoma City OK 73120-1967 Ph: () - | Achieve Health Family Medicine Pllc 12401 N May Ave Ste 102 Oklahoma City OK 73120-1967 Ph: (405) 631-0483 |
| NPI Number | 1164181244 |
|---|---|
| Provider Enumeration Date | 12/15/2021 |
| Last Update Date | 05/19/2024 |
| Medicare PECOS PAC ID | 8123412087 |
|---|---|
| Medicare Enrollment ID | O20220218001993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164181244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ryan D Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922094184 PECOS PAC ID: 5294649380 Enrollment ID: I20031113000413 |
| Provider Name | Morgan Leah Segrest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326573692 PECOS PAC ID: 7810253994 Enrollment ID: I20171106001143 |
| Provider Name | Shelley J Mcclure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184392649 PECOS PAC ID: 8123426921 Enrollment ID: I20211008000811 |
| Provider Name | Lacey Elizabeth Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730848201 PECOS PAC ID: 1759775976 Enrollment ID: I20220303000943 |
| Provider Name | Angelia Estelene Casteel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154097863 PECOS PAC ID: 9234516352 Enrollment ID: I20220511001385 |
| Provider Name | Charley Cade Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437830353 PECOS PAC ID: 6406210897 Enrollment ID: I20230919001588 |
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