| Your Health Llc | |
|
7530 Nw 23rd St Bethany OK 73008-4921 | |
| (405) 735-9348 | |
| (405) 703-3116 |
| Full Name | Your Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7530 Nw 23rd St, Bethany, Oklahoma |
| Authorized Official Name and Position | Jesse Lee Smith (CFO) |
| Authorized Official Contact | 4057359348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Health Llc Po Box 892410 Oklahoma City OK 73189-2410 Ph: (405) 735-9348 | Your Health Llc 7530 Nw 23rd St Bethany OK 73008-4921 Ph: (405) 735-9348 |
| NPI Number | 1396385431 |
|---|---|
| Provider Enumeration Date | 01/07/2020 |
| Last Update Date | 01/07/2020 |
| Medicare PECOS PAC ID | 3870922008 |
|---|---|
| Medicare Enrollment ID | O20200408004584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396385431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
| Provider Name | Miriam E Thompson Mathew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275675662 PECOS PAC ID: 0345313284 Enrollment ID: I20080724000842 |
| Provider Name | John E Beavers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386615839 PECOS PAC ID: 1355481995 Enrollment ID: I20091212000114 |
| Provider Name | Stephanie Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558786541 PECOS PAC ID: 4688899818 Enrollment ID: I20140702001011 |
| Provider Name | Breanna J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033645007 PECOS PAC ID: 4880952886 Enrollment ID: I20171221000383 |
| Provider Name | Christine E Noteboom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225541576 PECOS PAC ID: 7719247162 Enrollment ID: I20180205001730 |
| Provider Name | Karen Christine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255831657 PECOS PAC ID: 0345586665 Enrollment ID: I20190108001548 |
| Provider Name | Larry S Elliott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770933277 PECOS PAC ID: 1153659875 Enrollment ID: I20190820001052 |
| Provider Name | Erin M Olmsted |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053968818 PECOS PAC ID: 2769814318 Enrollment ID: I20191120000225 |
| Provider Name | Isaac Ilaoa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336415280 PECOS PAC ID: 2668796202 Enrollment ID: I20200423003609 |
| Provider Name | Mallory Jo Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255963252 PECOS PAC ID: 7113357567 Enrollment ID: I20200427000354 |
| Provider Name | Rachel Danielle Branton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871143206 PECOS PAC ID: 8921417775 Enrollment ID: I20210506001576 |
| Provider Name | Leslie Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952949612 PECOS PAC ID: 1557760329 Enrollment ID: I20210527000697 |
| Provider Name | Devin Nicole Fugett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427630029 PECOS PAC ID: 1850792243 Enrollment ID: I20210623000439 |
| Provider Name | Dustin Ryan Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518537638 PECOS PAC ID: 6709280308 Enrollment ID: I20210804001055 |
| Provider Name | Brandi Nichole Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235801648 PECOS PAC ID: 0547650079 Enrollment ID: I20211124000288 |
| Provider Name | Elizabeth Brooke Sill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790166486 PECOS PAC ID: 1658623525 Enrollment ID: I20230328001243 |
| Provider Name | Shalan Velez-cope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104559756 PECOS PAC ID: 1759756190 Enrollment ID: I20230417001774 |
| Provider Name | Elizabeth A Gallaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033814785 PECOS PAC ID: 9830550672 Enrollment ID: I20230726003507 |
| Provider Name | Courtney A Bowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952024259 PECOS PAC ID: 9234593039 Enrollment ID: I20230913000093 |
| Provider Name | Kyle M Mccall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134871080 PECOS PAC ID: 8820447824 Enrollment ID: I20231216000033 |
| Provider Name | Haley K Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477265163 PECOS PAC ID: 7911343678 Enrollment ID: I20240315003138 |
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