Central Oklahoma Family Med Center | |
527 West 3rd St Konawa OK 74849 | |
(580) 925-3286 | |
(580) 925-2362 |
Full Name | Central Oklahoma Family Med Center |
---|---|
Speciality | Clinic/Center |
Location | 527 West 3rd St, Konawa, Oklahoma |
Authorized Official Name and Position | Brenda Ware (CEO) |
Authorized Official Contact | 5809253286 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Central Oklahoma Family Med Center 527 West 3rd Street Konawa OK 74849 Ph: (580) 925-3286 | Central Oklahoma Family Med Center 527 West 3rd St Konawa OK 74849 Ph: (580) 925-3286 |
NPI Number | 1831291293 |
---|---|
Provider Enumeration Date | 09/05/2006 |
Last Update Date | 01/31/2022 |
Medicare PECOS PAC ID | 9931189685 |
---|---|
Medicare Enrollment ID | O20040722001013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831291293 | NPI | - | NPPES |
100737160D | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Judy L Pearce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962407999 PECOS PAC ID: 6406845932 Enrollment ID: I20040510001364 |
Provider Name | Richard Troy Lehman |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1538126990 PECOS PAC ID: 4486644234 Enrollment ID: I20040514000277 |
Provider Name | Timothy W Medcalf |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1548221443 PECOS PAC ID: 9133181852 Enrollment ID: I20060525000213 |
Provider Name | Randall L Kemp |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326043803 PECOS PAC ID: 2062482391 Enrollment ID: I20070425000369 |
Provider Name | John C Siegle |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1710073044 PECOS PAC ID: 4688587751 Enrollment ID: I20070830000646 |
Provider Name | Erica R Sun |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689693467 PECOS PAC ID: 7214930635 Enrollment ID: I20071101000608 |
Provider Name | William H Chesser |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508959685 PECOS PAC ID: 8325070915 Enrollment ID: I20080409000073 |
Provider Name | Kelli A Rollins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700033867 PECOS PAC ID: 5496810855 Enrollment ID: I20090218000452 |
Provider Name | Phyllis M Wallace |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366486417 PECOS PAC ID: 2668511502 Enrollment ID: I20091205000121 |
Provider Name | Lynn D Baggett |
---|---|
Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1801032297 PECOS PAC ID: 1355480104 Enrollment ID: I20091208000256 |
Provider Name | Tawfik Z Ramadan |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1548252299 PECOS PAC ID: 0042351942 Enrollment ID: I20100113000659 |
Provider Name | Charles R Vest |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1992728844 PECOS PAC ID: 3173537065 Enrollment ID: I20100212000333 |
Provider Name | John K Falsarella |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861440455 PECOS PAC ID: 4880626472 Enrollment ID: I20100506000248 |
Provider Name | James F Wight |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972561116 PECOS PAC ID: 9739217191 Enrollment ID: I20100506000275 |
Provider Name | Semira Charboneau |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619975745 PECOS PAC ID: 4688662174 Enrollment ID: I20100820000058 |
Provider Name | Jody W Ardrey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881902377 PECOS PAC ID: 6800072885 Enrollment ID: I20110510000336 |
Provider Name | Laura L Dooley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780983130 PECOS PAC ID: 4688842321 Enrollment ID: I20110722000475 |
Provider Name | Stephanie R Mowdy |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1316178262 PECOS PAC ID: 4789821760 Enrollment ID: I20130510000417 |
Provider Name | Angela Yates Griffin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316350713 PECOS PAC ID: 4688890940 Enrollment ID: I20140722001067 |
Provider Name | Stephen Lynn Ogrady |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1699842161 PECOS PAC ID: 3678584471 Enrollment ID: I20150115000435 |
Provider Name | Amanda H Lawhorn |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457641862 PECOS PAC ID: 6406171412 Enrollment ID: I20150216001302 |
Provider Name | Qiong Mu Ross |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053705673 PECOS PAC ID: 9830491323 Enrollment ID: I20151229002638 |
Provider Name | Stephanie Anne Meeks |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1578884904 PECOS PAC ID: 6709181795 Enrollment ID: I20160301000547 |
Provider Name | Penni Cartlidge |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740644970 PECOS PAC ID: 0840583654 Enrollment ID: I20160801000647 |
Provider Name | Paul Borden Tucker |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861574717 PECOS PAC ID: 1456630730 Enrollment ID: I20161109000054 |
Provider Name | Jenna Geohagan |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1760879076 PECOS PAC ID: 8426343278 Enrollment ID: I20170207002850 |
Provider Name | Michel Cosby |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235673799 PECOS PAC ID: 9638446081 Enrollment ID: I20170606002348 |
Provider Name | Emily Katherine Payne |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437671328 PECOS PAC ID: 7719251347 Enrollment ID: I20170921000308 |
Provider Name | Melissa L Adams |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1285801282 PECOS PAC ID: 0345395877 Enrollment ID: I20171208002018 |
Provider Name | Charlysa Diana Gatlin Castillo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760910772 PECOS PAC ID: 8123389806 Enrollment ID: I20180220001401 |
Provider Name | Joshua Priddle |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154736346 PECOS PAC ID: 8022327311 Enrollment ID: I20180731002188 |
Provider Name | Amanda Lynn Cubit |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750882775 PECOS PAC ID: 9739437781 Enrollment ID: I20180807002892 |
Provider Name | Paul Franklin Warlick |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902030299 PECOS PAC ID: 6406007012 Enrollment ID: I20190117000492 |
Provider Name | Mahate Ann Parker |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1437476611 PECOS PAC ID: 0547483471 Enrollment ID: I20190122002609 |
Provider Name | Kelli Lowry |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1548886831 PECOS PAC ID: 8921421066 Enrollment ID: I20200708003130 |
Provider Name | Whitney Alyse Robertson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184213373 PECOS PAC ID: 8729493226 Enrollment ID: I20210216000322 |
Provider Name | Natasha Estep |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1700383148 PECOS PAC ID: 7214292127 Enrollment ID: I20220112001797 |
Provider Name | Miranda Knight-brown |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1063770212 PECOS PAC ID: 6507089430 Enrollment ID: I20220218001709 |
Provider Name | Tamar Windsor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922129253 PECOS PAC ID: 7214192202 Enrollment ID: I20220405000858 |
Provider Name | Kent Denson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285758904 PECOS PAC ID: 1153379185 Enrollment ID: I20220526002323 |
Provider Name | Aubrie Morgan Northcutt |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1891256657 PECOS PAC ID: 6103209739 Enrollment ID: I20220815003307 |
Provider Name | Curtis E Harris |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1235116013 PECOS PAC ID: 4284767484 Enrollment ID: I20221102002464 |
Provider Name | Allyn Elise Ross |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730824939 PECOS PAC ID: 0749667665 Enrollment ID: I20230202003248 |
Provider Name | Brooke Nicole Houck |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225735095 PECOS PAC ID: 2062887078 Enrollment ID: I20230405000580 |
Provider Name | Anthony Lee Shelton |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1992365597 PECOS PAC ID: 4688094006 Enrollment ID: I20230808003106 |
Provider Name | Justin Burnett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144845496 PECOS PAC ID: 2365896131 Enrollment ID: I20230927002564 |
Provider Name | Amber Ellyn Holbein |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184247900 PECOS PAC ID: 7416330782 Enrollment ID: I20230927003608 |
Provider Name | Sharon Weirick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699933911 PECOS PAC ID: 0648599803 Enrollment ID: I20231213004183 |
Provider Name | Lauren Mackenzie Vesely |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1770816217 PECOS PAC ID: 2769827229 Enrollment ID: I20240223004067 |
Provider Name | Emily Nicole Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649986431 PECOS PAC ID: 2668818824 Enrollment ID: I20240311000242 |
Provider Name | Gayla Beth Branscum |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1255538237 PECOS PAC ID: 6204274616 Enrollment ID: I20240404001599 |
Central Oklahoma Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3266 Fax: 580-925-9149 | |
Central Oklahoma Family Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 |