TEAM CLINIC MANAGEMENT PARTNERS LLC (NPI# 1134606064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134606064 |
| Entity Type | Organization |
| Organization Name | TEAM CLINIC MANAGEMENT PARTNERS LLC |
| Practice Address |
1401 E Independence St Shawnee OK 74804-4225 |
| Mailing Address |
3112 Cooke Way Oklahoma City OK 73179-2401 |
| Practice Telephone | 4056006869 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2020-04-15 |
| Authorized Official Name | KEVIN PENWELL (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4056006869 |
| Authorized Official Credential | DO |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476654 | Team Clinic Management Partners LLC | Clinic/Center | 372 N Cobb, Caney, OK 74533 | 2020-10-29 |
| 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 |
| 1295346609 | Team Clinic Management Partners LLC | Clinic/Center | 7200 E Quincy Pl, Broken Arrow, OK 74014-4522 | 2020-08-11 |
| Street Address |
1401 E INDEPENDENCE ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-4225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409370 | Team Clinic Management Partners LLC | Clinic/Center | 1601 Gordon Cooper Dr Ste 1907, Shawnee, OK 74801-9002 | 2019-04-16 |
| 1942787874 | Team Clinic Management Partners LLC | Clinic/Center | 2600 N Union Ave, Shawnee, OK 74804-2966 | 2018-07-24 |
| 1033696968 | Team Clinic Management Partners LLC | Clinic/Center | 1111 N Kennedy Ave Ste B, Shawnee, OK 74801-4712 | 2018-07-24 |
| 1033696109 | Team Clinic Management Partners | Clinic/Center | 800 N Louisa Ave, Shawnee, OK 74801-5832 | 2018-07-23 |
| 1689151755 | Team Clinic Management Partners LLC | Clinic/Center | 1001 N Kennedy Ave, Shawnee, OK 74801-4730 | 2018-07-23 |
| 1295212421 | Team Clinic Management Partners LLC | Clinic/Center | 1831 Airport Dr, Shawnee, OK 74804-2640 | 2018-07-20 |
| 1730666967 | Team Clinic Management Partners | Clinic/Center | 412 N Draper Ave, Shawnee, OK 74801-7410 | 2018-07-20 |
| 1952566952 | Redi-care Clinic, P. C. | Clinic/Center | 753 E Independence St, Shawnee, OK 74804-4012 | 2008-07-20 |
| 1376197558 | Vera Whole Health Ks, Pa | Clinic/Center | 10824 Shawnee Mission Pkwy, Shawnee, KS 66203-3512 | 2019-07-26 |
| 1679134688 | Team Clinic Management Partners | Clinic/Center | 500 W University St, Shawnee, OK 74804-2522 | 2019-06-21 |
| Find all providers in SHAWNEE | ||||
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| 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.