Variety Care, Straka | |
1025 Straka Ter Oklahoma City OK 73139-2544 | |
(405) 632-6688 | |
(405) 604-0708 |
Full Name | Variety Care, Straka |
---|---|
Speciality | Clinic/Center |
Location | 1025 Straka Ter, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Tim Reddout (CFO) |
Authorized Official Contact | 4056326688 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Variety Care, Straka 3000 N Grand Blvd Oklahoma City OK 73107-1818 Ph: (405) 632-6688 | Variety Care, Straka 1025 Straka Ter Oklahoma City OK 73139-2544 Ph: (405) 632-6688 |
NPI Number | 1780697813 |
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Provider Enumeration Date | 08/13/2006 |
Last Update Date | 02/26/2020 |
Medicare PECOS PAC ID | 1557260007 |
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Medicare Enrollment ID | O20040105000467 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780697813 | NPI | - | NPPES |
100734110B | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Oklahoma) | Primary |
Provider Name | Belinda G Broady-symes |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1174537278 PECOS PAC ID: 9234024019 Enrollment ID: I20040729001325 |
Provider Name | Theresa S Garton |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1437180858 PECOS PAC ID: 3779556782 Enrollment ID: I20040823000013 |
Provider Name | Kumar Ennamuri |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396783056 PECOS PAC ID: 9436105616 Enrollment ID: I20050812000116 |
Provider Name | Pamela S Miles |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1619945466 PECOS PAC ID: 5597789107 Enrollment ID: I20060123000540 |
Provider Name | Catherine W Gardner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730270463 PECOS PAC ID: 3577560630 Enrollment ID: I20061102000255 |
Provider Name | Shana R Solis |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1154493872 PECOS PAC ID: 8628079100 Enrollment ID: I20070125000535 |
Provider Name | Heather D Jones |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1407950504 PECOS PAC ID: 7416956412 Enrollment ID: I20080121000160 |
Provider Name | Lydia Nightingale |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1356497291 PECOS PAC ID: 4082785100 Enrollment ID: I20080618000096 |
Provider Name | Julie O Mccoy |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932365889 PECOS PAC ID: 1153481890 Enrollment ID: I20081125000639 |
Provider Name | Deborah S Murnan |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1477718542 PECOS PAC ID: 0244385011 Enrollment ID: I20090831000195 |
Provider Name | Jubel Jhun Sullano Bilbao |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437354479 PECOS PAC ID: 3375689359 Enrollment ID: I20091005000536 |
Provider Name | Daniel C Clinkenbeard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629076963 PECOS PAC ID: 9830238740 Enrollment ID: I20091207000532 |
Provider Name | Elizabeth A Foote |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1871632083 PECOS PAC ID: 3971635343 Enrollment ID: I20100720001037 |
Provider Name | Andrew L Foote |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1558400762 PECOS PAC ID: 8123150596 Enrollment ID: I20100720001056 |
Provider Name | Kyle A Stewart |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1457557571 PECOS PAC ID: 5991829335 Enrollment ID: I20100907001122 |
Provider Name | Devin G Mcadams |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1184683864 PECOS PAC ID: 3072598150 Enrollment ID: I20110124000531 |
Provider Name | Timothy R Fagan |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1477557452 PECOS PAC ID: 4385829084 Enrollment ID: I20110422000109 |
Provider Name | Julia H Reza |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1023220936 PECOS PAC ID: 2365507548 Enrollment ID: I20111205000411 |
Provider Name | Jacqueline Renee Watson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427344035 PECOS PAC ID: 7214102771 Enrollment ID: I20111212000379 |
Provider Name | Sheleatha M Taylor Bristow |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265744056 PECOS PAC ID: 2365619970 Enrollment ID: I20120123000805 |
Provider Name | Jorgee A Reyes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750502431 PECOS PAC ID: 3375704034 Enrollment ID: I20120405000694 |
Provider Name | Lisa J Hays |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962797019 PECOS PAC ID: 4082875364 Enrollment ID: I20120412000669 |
Provider Name | Nelson Ivan Agudelo-higuita |
---|---|
Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1194920074 PECOS PAC ID: 4587820535 Enrollment ID: I20120719000533 |
Provider Name | Amber D Wolfe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760757140 PECOS PAC ID: 3375784036 Enrollment ID: I20130724000013 |
Provider Name | Courtney Brooke Atchley |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1033306873 PECOS PAC ID: 5193968782 Enrollment ID: I20130829000577 |
Provider Name | Kanita L Moser |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073705471 PECOS PAC ID: 2668527342 Enrollment ID: I20140321001225 |
Provider Name | Kathryn E Knight |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003237108 PECOS PAC ID: 0244462356 Enrollment ID: I20140403001528 |
Provider Name | Gloria P Ayisi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285044461 PECOS PAC ID: 7416174636 Enrollment ID: I20140812002382 |
Provider Name | Jade Dunn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821404377 PECOS PAC ID: 1153643077 Enrollment ID: I20141204000832 |
Provider Name | Summer Z Jatala |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982998290 PECOS PAC ID: 4385966043 Enrollment ID: I20141208001171 |
Provider Name | April J Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154758530 PECOS PAC ID: 2466764493 Enrollment ID: I20150706001810 |
Provider Name | Violet Cohen |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1063493187 PECOS PAC ID: 1052611928 Enrollment ID: I20151125000414 |
Provider Name | Amanda Martin |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1497073290 PECOS PAC ID: 1658674791 Enrollment ID: I20160122000965 |
Provider Name | L'tora Bryant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689032179 PECOS PAC ID: 2264738921 Enrollment ID: I20160308000197 |
Provider Name | Taimur Paracha |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922348036 PECOS PAC ID: 5597063107 Enrollment ID: I20160415000226 |
Provider Name | Elizabeth Diane Rainwater |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851735658 PECOS PAC ID: 6305166489 Enrollment ID: I20160624000967 |
Provider Name | Lisa Truong |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1376981399 PECOS PAC ID: 0648561217 Enrollment ID: I20160629001279 |
Provider Name | Sandra Jean Gilliland |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1003957846 PECOS PAC ID: 7810280864 Enrollment ID: I20160728000117 |
Provider Name | Nipun Kotha |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1043443013 PECOS PAC ID: 5991098840 Enrollment ID: I20160729000838 |
Provider Name | Jenney Z Qin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154687010 PECOS PAC ID: 8729372446 Enrollment ID: I20160803001557 |
Provider Name | Jason R Graham |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1841202298 PECOS PAC ID: 2466457254 Enrollment ID: I20160818000603 |
Provider Name | Jennifer Lynn Evans |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1366842676 PECOS PAC ID: 2860788569 Enrollment ID: I20160907000189 |
Provider Name | Melissa Sue Alfred |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295193910 PECOS PAC ID: 9234435421 Enrollment ID: I20170120002281 |
Provider Name | Sharon Martin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598213514 PECOS PAC ID: 1557646171 Enrollment ID: I20170322002463 |
Provider Name | Mary M Hines |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588078331 PECOS PAC ID: 0941520266 Enrollment ID: I20170725001711 |
Provider Name | Nicole O Hickson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720492473 PECOS PAC ID: 2860763257 Enrollment ID: I20170803000721 |
Provider Name | Geneva Hirshburg |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1154764892 PECOS PAC ID: 5799050753 Enrollment ID: I20171002002537 |
Provider Name | Rosita Rodarte |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1679978175 PECOS PAC ID: 9436417482 Enrollment ID: I20171220000927 |
Provider Name | Kourtney Peterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093165227 PECOS PAC ID: 8123387131 Enrollment ID: I20180122000375 |
Provider Name | Nissy Mathew |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689020067 PECOS PAC ID: 5294095659 Enrollment ID: I20180202000206 |
Provider Name | Tenessa G Pinkerton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407374820 PECOS PAC ID: 6406121425 Enrollment ID: I20180207001752 |
Provider Name | Brenda Rodriguez Nguyen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740780162 PECOS PAC ID: 0941564066 Enrollment ID: I20180425002590 |
Provider Name | Robert Ward |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1295115962 PECOS PAC ID: 4789932666 Enrollment ID: I20180809000712 |
Provider Name | Kathryn Kramer |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1477967230 PECOS PAC ID: 1951691229 Enrollment ID: I20180815000103 |
Provider Name | Karen Suzanne Sargent |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1275886459 PECOS PAC ID: 0143534073 Enrollment ID: I20180905002032 |
Provider Name | Renate Sabine Winningham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497222616 PECOS PAC ID: 1355689704 Enrollment ID: I20190211002969 |
Provider Name | Hilda Rodriguez |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1619322211 PECOS PAC ID: 0446591275 Enrollment ID: I20190404001639 |
Provider Name | Musheni Nsa |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1679863369 PECOS PAC ID: 6507150489 Enrollment ID: I20190826001105 |
Provider Name | Daisy Mabel Carlson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487085726 PECOS PAC ID: 8527492552 Enrollment ID: I20191230001169 |
Provider Name | Jessica Susan Lutz |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1730594326 PECOS PAC ID: 3678872793 Enrollment ID: I20191230001969 |
Provider Name | Usman Baber |
---|---|
Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1538378427 PECOS PAC ID: 7012186513 Enrollment ID: I20200323002518 |
Provider Name | Bency John Sony |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932665304 PECOS PAC ID: 7315376878 Enrollment ID: I20200403001410 |
Provider Name | Regina Tomichen |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1801277876 PECOS PAC ID: 1052625241 Enrollment ID: I20200709000245 |
Provider Name | Alexis Suzanne Shelton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205466240 PECOS PAC ID: 4587088729 Enrollment ID: I20200721004315 |
Provider Name | Jackeline Vanessa Pickelsimer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629685946 PECOS PAC ID: 7810317815 Enrollment ID: I20201013001567 |
Provider Name | Deniese S Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144810698 PECOS PAC ID: 9436564457 Enrollment ID: I20210224001137 |
Provider Name | Mary Claire J Carbonell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457956286 PECOS PAC ID: 4385051473 Enrollment ID: I20210408001313 |
Provider Name | Jessica Williams |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1861010589 PECOS PAC ID: 9931501319 Enrollment ID: I20210707003073 |
Provider Name | Molly Marie Denny |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1164927778 PECOS PAC ID: 3173926565 Enrollment ID: I20210722001904 |
Provider Name | Emily Cahill |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1407346315 PECOS PAC ID: 0042613812 Enrollment ID: I20210730002465 |
Provider Name | Conner Eugene Johnson |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1831683101 PECOS PAC ID: 1052715927 Enrollment ID: I20210814000070 |
Provider Name | Karla V Sigala |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1891468310 PECOS PAC ID: 5698170421 Enrollment ID: I20210817003321 |
Provider Name | Stephanie N White Hopkins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841843265 PECOS PAC ID: 0345638516 Enrollment ID: I20211021001226 |
Provider Name | Noha Farid Mohamad Ahmad Hamada |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982195749 PECOS PAC ID: 6800284738 Enrollment ID: I20211027000121 |
Provider Name | Sylvia A Rivera |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518156371 PECOS PAC ID: 7416110184 Enrollment ID: I20211105000499 |
Provider Name | Lauren Ruiz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255097671 PECOS PAC ID: 8426449752 Enrollment ID: I20211222000167 |
Provider Name | Maria Lee Meyer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982374831 PECOS PAC ID: 2860888005 Enrollment ID: I20220415000290 |
Provider Name | Andrea Lynn Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831737667 PECOS PAC ID: 4486041126 Enrollment ID: I20220427000556 |
Provider Name | David Alan Ciesla |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1174665111 PECOS PAC ID: 6709266331 Enrollment ID: I20220629001295 |
Provider Name | Rebecca J King Rackley |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1790899474 PECOS PAC ID: 7113307687 Enrollment ID: I20220630002488 |
Provider Name | Kelsey R Damron |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1427519511 PECOS PAC ID: 1355676891 Enrollment ID: I20220722002199 |
Provider Name | Mary K Nixon |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1003307935 PECOS PAC ID: 4688924368 Enrollment ID: I20220802002173 |
Provider Name | Ramina Golshani |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1306328992 PECOS PAC ID: 9931582624 Enrollment ID: I20220812001412 |
Provider Name | Robyn Nettles |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467011015 PECOS PAC ID: 9931582517 Enrollment ID: I20220815001320 |
Provider Name | Jeaneth Rocio Hidalgo De Rangel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659006708 PECOS PAC ID: 0244614501 Enrollment ID: I20220906001028 |
Provider Name | Hannah E Moery |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1790274199 PECOS PAC ID: 3476937616 Enrollment ID: I20220907001246 |
Provider Name | Valerie Shannon Price |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760117477 PECOS PAC ID: 4981089851 Enrollment ID: I20220913001046 |
Provider Name | Lindsay Jean Barron |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891429882 PECOS PAC ID: 3072998707 Enrollment ID: I20220916001767 |
Provider Name | Glenn R Davis |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1003806431 PECOS PAC ID: 8527080936 Enrollment ID: I20221031000163 |
Provider Name | Brianna Lamoso |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003562448 PECOS PAC ID: 1153791884 Enrollment ID: I20221221001600 |
Provider Name | Landon Kale Rodriguez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700596277 PECOS PAC ID: 7810361102 Enrollment ID: I20230329000216 |
Provider Name | Emerald Brooke Ferguson |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1760172316 PECOS PAC ID: 4284091109 Enrollment ID: I20230608002235 |
Provider Name | Ashish D Gupta |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992148076 PECOS PAC ID: 3375835036 Enrollment ID: I20230615002115 |
Provider Name | Hitesh Kayastha |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1730871096 PECOS PAC ID: 6507224599 Enrollment ID: I20230623000961 |
Provider Name | Hector L Rivera Reyes |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1457583585 PECOS PAC ID: 9739302340 Enrollment ID: I20230719004421 |
Provider Name | Mona Bahavar |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1508489642 PECOS PAC ID: 2264893973 Enrollment ID: I20230727002773 |
Provider Name | Lindsay Erin Aguilar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619538469 PECOS PAC ID: 6507228897 Enrollment ID: I20230818000206 |
Provider Name | Nathan Bugg |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1508505280 PECOS PAC ID: 1355703653 Enrollment ID: I20230818000864 |
Provider Name | Treyon L Grant |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1881325025 PECOS PAC ID: 2567826464 Enrollment ID: I20230911003669 |
Provider Name | Carlie M Pearson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144845876 PECOS PAC ID: 1052792678 Enrollment ID: I20231002002197 |
Provider Name | Karen Trang Cheng |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1942822945 PECOS PAC ID: 1850746728 Enrollment ID: I20231012001555 |
Provider Name | Michael J Kierl |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1821075847 PECOS PAC ID: 8022465970 Enrollment ID: I20231114002758 |
Provider Name | Rahil Shariatzadeh Khalili |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750096301 PECOS PAC ID: 9234596271 Enrollment ID: I20231201000382 |
Provider Name | Sierra Victoria Lacey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417733924 PECOS PAC ID: 4284082017 Enrollment ID: I20231204003157 |
Provider Name | Karen Denise Holubec-sorsby |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1528167913 PECOS PAC ID: 9638528524 Enrollment ID: I20231218003796 |
Provider Name | Desma Mckinney |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1871612911 PECOS PAC ID: 4880987858 Enrollment ID: I20240116001638 |
Provider Name | Vinh Phung |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1518456136 PECOS PAC ID: 6901254531 Enrollment ID: I20240116003248 |
Provider Name | Tracy Nelson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1710134473 PECOS PAC ID: 0042660961 Enrollment ID: I20240117001798 |
Provider Name | Sally Kerr |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1427090018 PECOS PAC ID: 5698068534 Enrollment ID: I20240118003245 |
Provider Name | Jessica Vaught |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1326489279 PECOS PAC ID: 7416205349 Enrollment ID: I20240118003357 |
Provider Name | April Ann Keith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639631781 PECOS PAC ID: 2769835792 Enrollment ID: I20240125004729 |
Provider Name | Lindsey Renee Price |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538855333 PECOS PAC ID: 7012360316 Enrollment ID: I20240201003551 |
Provider Name | Susana Makintubee |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124226741 PECOS PAC ID: 4587957428 Enrollment ID: I20240205002171 |
Provider Name | Jacqueline Freitas |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1669839502 PECOS PAC ID: 2365865540 Enrollment ID: I20240221000972 |
Provider Name | Jacquelyn Jones |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1427321157 PECOS PAC ID: 4688019995 Enrollment ID: I20240227000801 |
Provider Name | Maurene Pantaleano |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1750936993 PECOS PAC ID: 3476901992 Enrollment ID: I20240301001843 |
Provider Name | Jennifer Mirossay |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1770106189 PECOS PAC ID: 0749627628 Enrollment ID: I20240327002676 |
Provider Name | Jacob Epperson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1578729521 PECOS PAC ID: 4082973037 Enrollment ID: I20240423002315 |
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 |