CRESTCARE FAMILY MEDICINE,PLLC (NPI# 1174139554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174139554 |
| Entity Type | Organization |
| Organization Name | CRESTCARE FAMILY MEDICINE,PLLC |
| Practice Address |
817 S Elm Pl Ste 104 Broken Arrow OK 74012-5369 |
| Practice Telephone | 9182519698 |
| Practice Fax Number | 4052419022 |
| Mailing Telephone | 9182519698 |
| Mailing Fax Number | 4052419022 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | DR. GAURANGI M ANKLESARIA (OWNER) |
| Authorized Official Telephone | 9182519698 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
817 S ELM PL STE 104 |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-5369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855640 | Charger Health Group Pllc | Family Medicine | 511 N Aspen Ave, Broken Arrow, OK 74012-2220 | 2020-09-14 |
| 1730606294 | Tulsa Pain Care Group LLC | Family Medicine | 817 S Elm Pl Ste 106, Broken Arrow, OK 74012-5369 | 2017-08-25 |
| 1760912075 | Total Care Physicians Group | Family Medicine | 2601 N Aspen Ave Ste 1011, Broken Arrow, OK 74012-1127 | 2017-06-19 |
| 1922441591 | Medstaff PC | Family Medicine | 1749 N Aspen Ave, Suite 1757, Broken Arrow, OK 74012 | 2013-04-12 |
| 1528388717 | Robert L Valentine | Family Medicine | 1801 E Kenosha St, Broken Arrow, OK 74012-2098 | 2010-06-10 |
| 1235468745 | King's Court Family Medicine | Family Medicine | 1615 S Eucalyptus Ave Ste 211, Broken Arrow, OK 74012-5993 | 2009-12-11 |
| 1306967088 | Cathleen E Vandergriff | Family Medicine | 2643 E Albany St Apt C, Broken Arrow, OK 74014-4634 | 2007-04-02 |
| 1053431452 | Family Care of Broken Arrow, Inc. | Family Medicine | 3100 S. Elm Pl., Suite A, Broken Arrow, OK 74012-7910 | 2007-03-30 |
| 1659405488 | Broken Arrow Family Practice Center | Family Medicine | 817 S Elm Pl Ste A, Broken Arrow, OK 74012-5369 | 2007-03-15 |
| 1588728836 | Ahs Oklahoma Physician Group, LLC | Family Medicine | 1551 N. 9th Street, Broken Arrow, OK 74012 | 2006-12-21 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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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.