| Good Shepherd Community Clinic, Inc. | |
|
20 12th Ave Nw Ardmore OK 73401-5722 | |
| (580) 223-3411 | |
| (580) 223-6614 |
| Full Name | Good Shepherd Community Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 20 12th Ave Nw, Ardmore, Oklahoma |
| Authorized Official Name and Position | Teresa Myers (CEO) |
| Authorized Official Contact | 5802233411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Community Clinic, Inc. 20 12th Ave Nw Ardmore OK 73401-5722 Ph: (580) 223-3411 | Good Shepherd Community Clinic, Inc. 20 12th Ave Nw Ardmore OK 73401-5722 Ph: (580) 223-3411 |
| NPI Number | 1285010413 |
|---|---|
| Provider Enumeration Date | 08/11/2015 |
| Last Update Date | 02/22/2022 |
| Medicare PECOS PAC ID | 4284936337 |
|---|---|
| Medicare Enrollment ID | O20160106000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285010413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Thomas W Mcculloh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407879661 PECOS PAC ID: 0345133013 Enrollment ID: I20040316001348 |
| Provider Name | Kerri Ann Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861677254 PECOS PAC ID: 4486731064 Enrollment ID: I20080407000449 |
| Provider Name | Michael W Carnahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871607903 PECOS PAC ID: 6608769377 Enrollment ID: I20100316000116 |
| Provider Name | Tausha Zann Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023251360 PECOS PAC ID: 4183898273 Enrollment ID: I20111130000326 |
| Provider Name | Jahannah Harper Jamelarin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538393137 PECOS PAC ID: 2567600026 Enrollment ID: I20151214002691 |
| Provider Name | Michelle Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144741661 PECOS PAC ID: 4981979002 Enrollment ID: I20170928004009 |
| Provider Name | Terrick Lloyd Washington |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184282329 PECOS PAC ID: 9032445754 Enrollment ID: I20190801001700 |
| Provider Name | Lacy Diane Westfall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184200669 PECOS PAC ID: 8224415435 Enrollment ID: I20220519001170 |
| Provider Name | Pamela Sue Kerkstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821249293 PECOS PAC ID: 2860857166 Enrollment ID: I20230419003201 |
| Provider Name | Christologus Onyinye Obi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548970437 PECOS PAC ID: 0941658884 Enrollment ID: I20231202000494 |
Mercy Health Services-southern Region, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 15th Ave Nw, Ardmore, OK 73401 Phone: 580-223-3737 Fax: 580-226-5679 | |
Wilson Loughridge Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 15th Ave Nw, Ardmore, OK 73401 Phone: 580-226-1010 Fax: 580-226-1011 | |
Alexander P Gurrola Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 812 12th Ave Nw, Ardmore, OK 73401 Phone: 580-226-6500 Fax: 580-226-6524 | |
Texoma Collaborative Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 15th Ave Nw, Ardmore, OK 73401 Phone: 580-798-5015 | |
Schafer Medical Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 Isabel St, Ardmore, OK 73401 Phone: 580-223-5432 Fax: 580-223-6076 | |
Dot Ardmore Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 S Commerce St, Ardmore, OK 73401 Phone: 580-490-9414 Fax: 580-490-9067 | |
Doctors Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Isabel, Ardmore, OK 73401 Phone: 580-223-5432 |