BRISTOW ENDEAVOR HEALTHCARE, LLC (NPI# 1275093098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275093098 |
| Entity Type | Organization |
| Organization Name | BRISTOW ENDEAVOR HEALTHCARE, LLC |
| Practice Address |
1005 Mitacek Ave Prague OK 74864 |
| Mailing Address |
3741 S Peoria Ave Tulsa OK 74105-3264 |
| Practice Telephone | 4055663411 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |
| Authorized Official Name | JAN ELLEN WINTER (CEO) |
| Authorized Official Telephone | 9183672215 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRISTOW ENDEAVOR HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Prague Healthcare Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679045439 | Bristow Endeavor Healthcare, LLC | Family Medicine | 900 Ok-33 Truck, Drumright, OK 74030 | 2018-12-18 |
| 1942700919 | Bristow Endeavor Healthcare, LLC | Internal Medicine | 700 W 7th Ave Ste 5, Bristow, OK 74010-2302 | 2018-02-16 |
| 1649779216 | Bristow Endeavor Healthcare, LLC | Pain Medicine | 512 N. Franklin Street, 2nd Floor, Jenks, OK 74037 | 2018-02-08 |
| 1699283143 | Bristow Endeavor Healthcare, LLC | Internal Medicine | 1116 Monvel Ave., Chandler, OK 74834 | 2018-01-18 |
| 1114435666 | Bristow Endeavor Healthcare, LLC | Special Hospital | 3029 W. Main Street, Jenks, OK 74037 | 2018-01-18 |
| 1942718499 | Bristow Endeavor Healthcare, LLC | Internal Medicine | 607 S. Broadway Street, Coweta, OK 74429 | 2018-01-18 |
| 1134780265 | Bristow Endeavor Healthcare, LLC | Special Hospital | 2340 E Main St, Cushing, OK 74023-2905 | 2019-06-28 |
| 1295243749 | Bristow Endeavor Healthcare, LLC | Internal Medicine | 2340 E. Main Street, Cushing, OK 74023 | 2018-01-18 |
| 1265863583 | Bristow Endeavor Healthcare, LLC | Medicare Defined Swing Bed Unit | 700 W 7th Ave, Suite 6, Bristow, OK 74010-2302 | 2013-12-12 |
| Street Address |
1005 MITACEK AVE |
| City | PRAGUE |
| State | OK |
| Zip Code | 74864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699186817 | Helping Hands Home Care, Pllc | Case Management | 517 Jim Thorpe Blvd, Prague, OK 74864 | 2014-05-09 |
| 1386077121 | Jennifer Cook | Case Manager/Care Coordinator | 971 South Jim Thorpe Blvd, Prague, OK 74864 | 2013-08-15 |
| 1104103316 | Syretta Nikia Pittman | Case Manager/Care Coordinator | 1021 South Jim Thorpe Blvd, Prague, OK 74864 | 2011-11-16 |
| 1891009312 | Chasitee Qwinette Burdine | Contractor | 57533 Moccasin Trail Rd, Prague, OK 74864 | 2010-07-27 |
| 1689908261 | Charles Albert Cashman | Dentist | 1201 Jim Thorpe, Suite One, Prague, OK 74864 | 2009-09-29 |
| 1598911752 | Central Oklahoma Family Medical Center | Clinic/Center | Nbu 1706 Highway 99 South, Prague, OK 74864 | 2008-08-07 |
| 1679746234 | Mark Allen White | Counselor | 1025 Meadowbrook Ave, Prague, OK 74864 | 2008-04-03 |
| 1770751752 | Mary Ann Ward | Physician Assistant | 1322 Klabzuba Avenue, Prague, OK 74864 | 2008-02-13 |
| 1487837167 | Land of Hope | Community/Behavioral Health | 57523 Moccasin Trail Road, Prague, OK 74864 | 2007-12-17 |
| 1720290539 | Central Ok Family Med Ctr | Clinic/Center | Rt 1 Box 85a, Prague, OK 74864 | 2007-05-04 |
| Find all providers in zip 74864 | ||||
| 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 |
|---|---|---|---|---|
| 1801992243 | Darryl W. Jackson | Family Medicine | 1322 Klabzuba St, Prague, OK 74864-4707 | 2006-09-15 |
| 1053348821 | Denny Ray Parton | Family Medicine | 1322 Klabzuba, Prague, OK 74864-1090 | 2006-06-27 |
| 1184981441 | Cameron C Henderson | Family Medicine | 1322 Klabzuba Ave, Prague, OK 74864-4900 | 2012-04-11 |
| 1730389735 | Prague Medical Alliance Pllc | Family Medicine | 1322 Klabzuba, Prague, OK 74864 | 2007-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1346841673 | Nugenex Plus Aprn-cnp Pllc | Family Medicine | 13425 Deer Spring Dr, Piedmont, OK 73078-3001 | 2020-11-03 |
| 1235739764 | Pinnacle Family Health Care | Family Medicine | 2781 Washington Drive, Suite 101, Norman, OK 73069 | 2020-10-26 |
| 1548868573 | Kayla Lynn Birchfield | Family Medicine | 220 W Jackson St, Crescent, OK 73028-8908 | 2020-10-12 |
| 1164039632 | Axiom Medical Solutions, LLC | Family Medicine | 14132 Se 134th St, Oklahoma City, OK 73165-7669 | 2020-09-28 |
| 1174139554 | Crestcare Family Medicine,pllc | Family Medicine | 817 S Elm Pl Ste 104, Broken Arrow, OK 74012-5369 | 2020-09-21 |
| 1346855640 | Charger Health Group Pllc | Family Medicine | 511 N Aspen Ave, Broken Arrow, OK 74012-2220 | 2020-09-14 |
| 1952916645 | Brandi Suzanne Shell | Family Medicine | 26471 E 141st St S, Coweta, OK 74429-5517 | 2020-09-10 |
| 1730793696 | Osumc Professional Services LLC | Family Medicine | 112 W 5th Street, Okmulgee, OK 74447-0000 | 2020-09-08 |
| 1104437219 | L and M Investments LLC | Family Medicine | 6001 Nw 139th St, Oklahoma City, OK 73142-1919 | 2020-08-12 |
| Find all providers with the same taxonomy | ||||
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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.