| Oklahoma City Indian Clinic | |
|
4913 W Reno Ave Oklahoma City OK 73127-6339 | |
| (405) 948-4900 | |
| (405) 948-4933 |
| Full Name | Oklahoma City Indian Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4913 W Reno Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Robin L Parker (DIRECTOR OF POLICY DEVELOPMENT) |
| Authorized Official Contact | 4059484900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma City Indian Clinic 4913 W Reno Ave Oklahoma City OK 73127-6339 Ph: (405) 948-4900 | Oklahoma City Indian Clinic 4913 W Reno Ave Oklahoma City OK 73127-6339 Ph: (405) 948-4900 |
| NPI Number | 1407969728 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 04/21/2021 |
| Medicare PECOS PAC ID | 3476617374 |
|---|---|
| Medicare Enrollment ID | O20090901000440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407969728 | NPI | - | NPPES |
| 100731010E | Medicaid | OK | |
| 100731010A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Ryan D Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154394369 PECOS PAC ID: 9638158074 Enrollment ID: I20040728001608 |
| Provider Name | Jin Kong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376793208 PECOS PAC ID: 9537210190 Enrollment ID: I20090623000149 |
| Provider Name | Janice K Hixson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629181623 PECOS PAC ID: 8325193097 Enrollment ID: I20090901000485 |
| Provider Name | Nicasio S Gutierrez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831281070 PECOS PAC ID: 8123121456 Enrollment ID: I20090901000602 |
| Provider Name | Regina M Rhoades |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558385708 PECOS PAC ID: 9739137241 Enrollment ID: I20090901000618 |
| Provider Name | Catherine C Waller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265537286 PECOS PAC ID: 0840345534 Enrollment ID: I20090901000645 |
| Provider Name | Michael Bryer-ash |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649205899 PECOS PAC ID: 5597652420 Enrollment ID: I20101005000234 |
| Provider Name | Zane D Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609099803 PECOS PAC ID: 8628267598 Enrollment ID: I20110106001254 |
| Provider Name | John A Dimmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700116282 PECOS PAC ID: 3779768536 Enrollment ID: I20110421000447 |
| Provider Name | Moira A Redcorn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902069206 PECOS PAC ID: 6002070034 Enrollment ID: I20120604000181 |
| Provider Name | Jeffrey L Watts |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912981499 PECOS PAC ID: 7618873977 Enrollment ID: I20130114000127 |
| Provider Name | Kristen D Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699069906 PECOS PAC ID: 4284850900 Enrollment ID: I20140731002788 |
| Provider Name | Paul S Dasari |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376709816 PECOS PAC ID: 2769609023 Enrollment ID: I20140808002237 |
| Provider Name | Kelly K Boucher |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528476207 PECOS PAC ID: 1456571017 Enrollment ID: I20141001002687 |
| Provider Name | Melody D Clanton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134594674 PECOS PAC ID: 9436452158 Enrollment ID: I20160129000296 |
| Provider Name | Janice Guthrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952775769 PECOS PAC ID: 5799064911 Enrollment ID: I20170221002429 |
| Provider Name | Sarah Eggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497170534 PECOS PAC ID: 9830419084 Enrollment ID: I20180131000910 |
| Provider Name | Sanjaykumar J Hapani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1952508533 PECOS PAC ID: 4486830213 Enrollment ID: I20190311000400 |
| Provider Name | Christian A Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497315824 PECOS PAC ID: 0749518173 Enrollment ID: I20190823000454 |
| Provider Name | Tyler S Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376993659 PECOS PAC ID: 2961794615 Enrollment ID: I20190910002936 |
| Provider Name | Tina M Gable |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891203980 PECOS PAC ID: 7719248467 Enrollment ID: I20191218000759 |
| Provider Name | John Scott Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548733249 PECOS PAC ID: 1254766421 Enrollment ID: I20200115003225 |
| Provider Name | Stephanie R Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659870814 PECOS PAC ID: 5698104537 Enrollment ID: I20200329000555 |
| Provider Name | Michalea N Parrott |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043807662 PECOS PAC ID: 8224445515 Enrollment ID: I20210405000204 |
| Provider Name | Brooke N Frantz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912497470 PECOS PAC ID: 7214286285 Enrollment ID: I20210908000565 |
| Provider Name | Barbara L Cunningham |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083811947 PECOS PAC ID: 9032284336 Enrollment ID: I20210908001259 |
| Provider Name | Jessica L Lafromboise |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487328688 PECOS PAC ID: 4880090323 Enrollment ID: I20210908001635 |
| Provider Name | Drew S Dawson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477902195 PECOS PAC ID: 0648558668 Enrollment ID: I20210908002242 |
| Provider Name | Donald W Nix |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114921897 PECOS PAC ID: 6204818149 Enrollment ID: I20210917000696 |
| Provider Name | Rochelle A Plummer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801202742 PECOS PAC ID: 8224435003 Enrollment ID: I20210922000071 |
| Provider Name | Grayson Neal Starbuck |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285006189 PECOS PAC ID: 8224447016 Enrollment ID: I20220131000567 |
| Provider Name | Bobby Lee Moore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770246688 PECOS PAC ID: 4082002076 Enrollment ID: I20220209000910 |
| Provider Name | Stetson Robert Schmitt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063752160 PECOS PAC ID: 0143615534 Enrollment ID: I20220322001690 |
| Provider Name | Aisa Marie Trice |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1053769810 PECOS PAC ID: 8820477417 Enrollment ID: I20220628003206 |
| Provider Name | Lakin Diane Urias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013653112 PECOS PAC ID: 0941680441 Enrollment ID: I20220630000112 |
| Provider Name | James Keith Cooper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306985569 PECOS PAC ID: 2466486071 Enrollment ID: I20220831000299 |
| Provider Name | Gabriella Elisabeth Pierce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225693450 PECOS PAC ID: 6406223478 Enrollment ID: I20221103001694 |
| Provider Name | Brooke Sarah Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124588827 PECOS PAC ID: 8426390832 Enrollment ID: I20221103001930 |
| Provider Name | Saeed Ahmad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285733881 PECOS PAC ID: 2668446121 Enrollment ID: I20221128000865 |
| Provider Name | Patrick P Lo |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1295742039 PECOS PAC ID: 9638213358 Enrollment ID: I20230202003011 |
| Provider Name | Darryl Stinson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922088392 PECOS PAC ID: 6103994900 Enrollment ID: I20230317001263 |
| Provider Name | William Ebke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659982510 PECOS PAC ID: 4981021862 Enrollment ID: I20230606002852 |
| Provider Name | Allison Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154961621 PECOS PAC ID: 0547630139 Enrollment ID: I20230623000645 |
| Provider Name | Paige Victoria Ford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902587801 PECOS PAC ID: 7315391513 Enrollment ID: I20230921002090 |
| Provider Name | Alixandra Nicole Fariss |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659083533 PECOS PAC ID: 7719331495 Enrollment ID: I20230928003336 |
| Provider Name | Tyler Harms |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952926628 PECOS PAC ID: 5496169252 Enrollment ID: I20231004000056 |
| Provider Name | Nicholas Wayne Begick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417518739 PECOS PAC ID: 3375990328 Enrollment ID: I20231113001581 |
| Provider Name | Jonkeeta Alice Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174687529 PECOS PAC ID: 8527161348 Enrollment ID: I20231116000693 |
| Provider Name | Hayden Rolan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780082347 PECOS PAC ID: 1456700848 Enrollment ID: I20231211001921 |
| Provider Name | Alicia Jeanne Barber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962647826 PECOS PAC ID: 7012367717 Enrollment ID: I20231220004277 |
| Provider Name | Amy Merrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235456740 PECOS PAC ID: 9537519137 Enrollment ID: I20231222000328 |
| Provider Name | Gina Marie Poisson Czarniecki |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144554239 PECOS PAC ID: 3476903907 Enrollment ID: I20231227000158 |
| Provider Name | Angela Don Lockhart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497176655 PECOS PAC ID: 3779933924 Enrollment ID: I20231229001655 |
| Provider Name | Charles Edward Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841790995 PECOS PAC ID: 7810340411 Enrollment ID: I20240131000870 |
| Provider Name | Kimberly Gail Farris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497915144 PECOS PAC ID: 8628421237 Enrollment ID: I20240131001230 |
| Provider Name | Veronica Valles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043522139 PECOS PAC ID: 9133572662 Enrollment ID: I20240131002128 |
| Provider Name | William Schnitz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1629015763 PECOS PAC ID: 8628038387 Enrollment ID: I20240208000422 |
| Provider Name | Kevin D Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194187468 PECOS PAC ID: 5294179016 Enrollment ID: I20240221000211 |
| Provider Name | Darla Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235436007 PECOS PAC ID: 0941644603 Enrollment ID: I20240221001783 |
| Provider Name | Anetra Lashawn House |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861747909 PECOS PAC ID: 7618311259 Enrollment ID: I20240222000295 |
| Provider Name | Crystal Lynn Frederick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1255112678 PECOS PAC ID: 2163867490 Enrollment ID: I20240227001449 |
| Provider Name | Lindsay Marie Masquat Yellow Robe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548931926 PECOS PAC ID: 6103262191 Enrollment ID: I20240313000783 |
| Provider Name | Amanda Lyn Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962667592 PECOS PAC ID: 1557417425 Enrollment ID: I20240322000137 |
| Provider Name | Shetira Lavi Voth |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285374629 PECOS PAC ID: 8820437825 Enrollment ID: I20240423002084 |
| Provider Name | Wudeneh Zewdie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538121421 PECOS PAC ID: 4981647963 Enrollment ID: I20240501001729 |
| Provider Name | Matthew Neil Kilgore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285188136 PECOS PAC ID: 4587006937 Enrollment ID: I20240530002154 |
Oklahoma Mental Health Council Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4420 N Lincoln Blvd, Oklahoma City, OK 73105 Phone: 405-424-7711 | |
American Current Care P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7100 S I-35 Service Road, Suite 7, Oklahoma City, OK 73149 Phone: 405-632-1002 Fax: 405-632-3131 | |
St Anthony Primary Care Physicians North Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6201 N Santa Fe Ave, Suite 2020, Oklahoma City, OK 73118 Phone: 405-272-5433 Fax: 405-272-5435 | |
Oklahoma Pain & Rehab Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2149 Sw 59th St, Suite 201, Oklahoma City, OK 73119 Phone: 405-681-5800 | |
Board Of Regents Of The Univ Of Okla Ou Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 | |
St Anthony North Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6201 N Santa Fe Ave, Suite 1010, Oklahoma City, OK 73118 Phone: 405-772-8687 Fax: 405-772-8688 | |
Barreto Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3418 Nw 135th St, Oklahoma City, OK 73120 Phone: 405-286-1075 Fax: 405-608-1075 |