Shortgrass Community Health Center, Inc | |
101 S Hudson St Altus OK 73521-4215 | |
(580) 688-2800 | |
(580) 688-2193 |
Full Name | Shortgrass Community Health Center, Inc |
---|---|
Speciality | Clinic/Center |
Location | 101 S Hudson St, Altus, Oklahoma |
Authorized Official Name and Position | Janet Lynn Tipton (OFFICE MANAGER) |
Authorized Official Contact | 6806882800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Shortgrass Community Health Center, Inc 400 East Sycamore Street Hollis OK 73550 Ph: (680) 688-2800 | Shortgrass Community Health Center, Inc 101 S Hudson St Altus OK 73521-4215 Ph: (580) 688-2800 |
NPI Number | 1982263752 |
---|---|
Provider Enumeration Date | 06/06/2019 |
Last Update Date | 12/14/2023 |
Medicare PECOS PAC ID | 9234385535 |
---|---|
Medicare Enrollment ID | O20121101000597 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982263752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | James L Johnson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477566180 PECOS PAC ID: 4082519301 Enrollment ID: I20031201000351 |
Provider Name | William J Kok |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033252804 PECOS PAC ID: 8325003932 Enrollment ID: I20080822000142 |
Provider Name | Manda Lea Stephens |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831471101 PECOS PAC ID: 3274706726 Enrollment ID: I20111227000311 |
Provider Name | Jennifer Kauffman |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588707202 PECOS PAC ID: 1850611997 Enrollment ID: I20150513001589 |
Provider Name | Kimberly Y Hestand |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114391315 PECOS PAC ID: 4082917190 Enrollment ID: I20160125000661 |
Provider Name | Melinda Ann Clinton |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1962914002 PECOS PAC ID: 9638579097 Enrollment ID: I20210607003231 |
Provider Name | Kimberly R Cline |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538811534 PECOS PAC ID: 8921493420 Enrollment ID: I20220321000361 |
Provider Name | Briana King |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1063075083 PECOS PAC ID: 8527409911 Enrollment ID: I20240516001641 |
Provider Name | Shawna D Ward |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1912363417 PECOS PAC ID: 0042651358 Enrollment ID: I20240516002560 |
Provider Name | Kimberly L Duel |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1285063750 PECOS PAC ID: 4688116973 Enrollment ID: I20240531003861 |
Provider Name | Brian J Bauer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083974836 PECOS PAC ID: 5698210581 Enrollment ID: I20240716001356 |
Altus Chiropractic Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 Falcon Rd, Altus, OK 73521 Phone: 580-482-4499 Fax: 580-482-4449 | |
Noble L Ballard.medical Clinic, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 East Broadway Street, Stuite 101, Altus, OK 73521 Phone: 580-480-1900 Fax: 580-477-1936 | |