DEER CREEK FAMILY HEALTHCARE AND WELLNESS CLINIC LLC (NPI# 1003227414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003227414 |
| Entity Type | Organization |
| Organization Name | DEER CREEK FAMILY HEALTHCARE AND WELLNESS CLINIC LLC |
| Practice Address |
19401 N. Portland Edmond OK 73012 |
| Practice Telephone | 4058128208 |
| Mailing Telephone | 4058128208 |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | KIM KNOX (NURSE PRACTITIONER / OWNER) |
| Authorized Official Telephone | 4058128208 |
| Authorized Official Credential | APRN-CNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
19401 N. PORTLAND |
| City | EDMOND |
| State | OK |
| Zip Code | 73012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013912 | Ashley Lambert | Counselor | 19501 N Pennsylvia, Apt 210, Edmond, OK 73012 | 2020-08-13 |
| 1699316083 | First Rate Eye Care Pllc | Optometrist | 1140 Nw 192nd St., Suite A, Edmond, OK 73012 | 2019-10-07 |
| 1659869881 | Brent Byers | Registered Nurse | 3040 Nw 179th Ct, Edmond, OK 73012 | 2018-04-24 |
| 1386173672 | John A Hale | Respiratory Therapist, Certified | 19100 Meadows Crossing Drive, Edmond, OK 73012 | 2017-06-08 |
| 1740715598 | Ryan Hays | Counselor | 620 Nw 178 St., Apt. 4c, Edmond, OK 73012 | 2017-04-28 |
| 1245691336 | Jessica Collins | Behavioral Analyst | 18217 Sandhurst Ct, Edmond, OK 73012 | 2016-03-16 |
| 1538545801 | Cynthia Ann Thompson | Case Manager/Care Coordinator | 1732 Kelly, Edmond, OK 73012 | 2015-08-10 |
| 1538564224 | Function Physical Therapy, LLC | Physical Therapist | 16502 N Pennsylvania Ave, Suite C, Edmond, OK 73012 | 2014-10-24 |
| 1316383649 | Ralphs Family Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Nw178th Street, Suite A, Edmond, OK 73012 | 2013-05-14 |
| 1457638454 | Sherry Davis Richardson | Contractor | 2545 Nw 179th Ct, Edmond, OK 73012 | 2011-11-04 |
| Find all providers in zip 73012 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205490984 | Thehealthworxllc | Clinic/Center | 1425 S Santa Fe Ave Ste G, Edmond, OK 73003-5910 | 2019-04-27 |
| 1457821548 | James Mcginn LLC | Clinic/Center | 849 E 33rd St Ste 201b, Edmond, OK 73013-5407 | 2018-11-30 |
| 1235612235 | Balance Medical, Inc. | Clinic/Center | 1019 Waterwood Pkwy Ste E-14, Edmond, OK 73034-5332 | 2018-09-14 |
| 1699012435 | Optima Weight & Wellness, LLC | Clinic/Center | 1489 E 15th St, Suite 108, Edmond, OK 73013-5054 | 2013-01-14 |
| 1396909446 | Bryant Street Family Medicine, P.C. | Clinic/Center | 305 South Bryant Ave, 110, Edmond, OK 73034 | 2008-07-17 |
| 1194741249 | Geoffrey W Hoover Md Pllc | Clinic/Center | 122 N Bryant Ave Ste 1, Edmond, OK 73034-6349 | 2006-07-14 |
| 1699391797 | Pollard Family Health and Wellness, LLC | Clinic/Center | 1404 Nw 186th St, Edmond, OK 73012-6202 | 2020-06-24 |
| 1922552348 | Careatc - City of Edmond | Clinic/Center | 28 E Main St, Suite 100, Edmond, OK 73034-4502 | 2016-08-15 |
| 1063525954 | Canyon Park Medical Group, Pllc | Clinic/Center | 1501 E 19th St, Edmond, OK 73013-6618 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476654 | Team Clinic Management Partners LLC | Clinic/Center | 372 N Cobb, Caney, OK 74533 | 2020-10-29 |
| 1184222705 | Essential Md, Pllc | Clinic/Center | 6316 E 102nd St Ste 100, Tulsa, OK 74137-7061 | 2020-10-15 |
| 1881292191 | Team Clinic Management Partners LLC | Clinic/Center | 3100 W New Orleans St, Broken Arrow, OK 74011-1468 | 2020-10-09 |
| 1972115392 | Team Clinic Management Partners LLC | Clinic/Center | 225 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-18 |
| 1093327413 | Team Clinic Management Partners LLC | Clinic/Center | 301 W New Orleans St, Broken Arrow, OK 74011-2206 | 2020-08-18 |
| 1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
| 1750992038 | Team Clinic Management Partners LLC | Clinic/Center | 251 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-11 |
| 1689285975 | Team Clinic Management Partners LLC | Clinic/Center | 301 E Tucson St, Broken Arrow, OK 74011-7235 | 2020-08-11 |
| 1417568700 | Team Clinic Management Partners LLC | Clinic/Center | 1351 E Albany St, Broken Arrow, OK 74012-8995 | 2020-08-11 |
| 1164033569 | Team Clinic Management Partners LLC | Clinic/Center | 6800 E Quincy Pl, Broken Arrow, OK 74014-4523 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DEER CREEK FAMILY HEALTHCARE AND WELLNESS CLINIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.