GRAND PRIMARY CARE CLINICS


Address: 5401 N Portland Ave, Suite 270, Oklahoma City, OK 73112-2121
Phone: 4056050108

GRAND PRIMARY CARE CLINICS (NPI# 1336697432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336697432
Entity Type Organization
Organization Name GRAND PRIMARY CARE CLINICS
Practice Address 5401 N Portland Ave
Suite 270
Oklahoma City
OK 73112-2121
Practice Telephone 4056050108
Practice Fax Number 4054630120
Mailing Telephone 4056050108
Mailing Fax Number 4054630120
Enumeration Date 2016-09-17
Last Update Date 2017-03-28
Authorized Official Name MR. JEFF J HUNTER (OWNER)
Authorized Official Telephone 4054182929
Authorized Official Credential DPH
Is Organization Subpart Y
Parent Organization Name KIMBACO, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner OK Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OK PENDING 05

Office Location

Street Address 5401 N PORTLAND AVE
SUITE 270
City OKLAHOMA CITY
State OK
Zip Code 73112-2121

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306827464 Oklahoma Surgery and Urology Center Clinic/Center 5401 N Portland Ave, Suite 100, Oklahoma City, OK 73112-2082 2005-11-07
1639618754 Oklahoma Mobile Lithotripter Associates, L.c. Clinic/Center 5401 N Portland Ave, Suite 640, Oklahoma City, OK 73112-2121 2017-02-22
1306397658 Infectious Disease Associates LLC General Acute Care Hospital 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 2016-10-21
1558735654 Hunter's Specialty Pharmacy LLC Pharmacy 5401 N Portland Ave, Suite 250, Oklahoma City, OK 73112-2121 2015-11-30
1871960195 Coordinated Care Health Solutions, LLC Clinical Medical Laboratory 5401 N Portland Ave, Suite 260, Oklahoma City, OK 73112-2121 2015-08-24
1952787806 Jessica Young Registered Nurse 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 2015-08-03
1750518601 Deaconess Physician Services LLC Durable Medical Equipment & Medical Supplies 5401 N Portland Ave, Suite 410, Oklahoma City, OK 73112-2121 2009-06-18
1982848719 Bushra Siddique Internal Medicine 5401 N Portland Ave, Suite 220, Oklahoma City, OK 73112-2121 2009-04-23
1629223771 Jerry R. Teel, Phd PC Audiologist-Hearing Aid Fitter 5401 N Portland Ave, Suite 540, Oklahoma City, OK 73112-2121 2008-11-17
1497926281 Deaconess Physician Services LLC Durable Medical Equipment & Medical Supplies 5401 N Portland Ave, Suite 390, Oklahoma City, OK 73112-2121 2008-03-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972145886 Crystopher J Long Physical Therapist Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 2019-10-11
1700448974 Joy Healthcare Services of Okc LLC Home Health 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 2019-07-08
1801380159 Crysten Cheatwood Do, PC Obstetrics & Gynecology 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 2018-06-20
1306352521 Victoria Ann Kappel Thoracic Surgery (Cardiothoracic Vascular Surgery) 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 2017-12-26
1871014886 Tanesia Michelle Smith Case Management 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 2017-06-29
1619414257 Edwige Gwanyama Student in an Organized Health Care Education/Training Program 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 2017-01-20
1619424017 Jennifer Beaver Peer Specialist 2808 Nw 31st, Oklahoma City, OK 73112 2016-09-02
1417305368 Gabriel Plank Counselor 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 2016-06-01
1912364365 Sams East Inc Durable Medical Equipment & Medical Supplies 4101 N May Ave, Oklahoma City, OK 73112 2016-01-15
1679938922 Portland Anesthesia Associates LLC Nurse Anesthetist, Certified Registered 5501 N Porland Ave, Oklahoma City, OK 73112 2015-12-30
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407471402 Brenda June Wilson Nurse Practitioner 8609 Sw 58th Cir, Oklahoma City, OK 73179-7910 2020-06-15
1508328998 Jennifer Alison Phillips Nurse Practitioner 6101 Ne 107th St, Oklahoma City, OK 73151-9560 2019-04-03
1952875981 Brieana Kay Dawson Nurse Practitioner 8501 Sw 48th St, Oklahoma City, OK 73179-4622 2019-01-12
1528539541 Sheena Margariet Musgrove Nurse Practitioner 3101 Hampshire Ln, Oklahoma City, OK 73179-1206 2018-12-17
1922593771 Terry Murdock Nurse Practitioner 6305 N Villa Ave Apt 13, Oklahoma City, OK 73112-7133 2018-06-25
1487157772 Misti Jayne Moon-harris Nurse Practitioner 8125 S Walker Ave Ste A, Oklahoma City, OK 73139-9417 2018-03-13
1114426053 Jennifer Lauren Lee Nurse Practitioner 4401 Mcauley Blvd Ste 1100, Oklahoma City, OK 73120-8533 2018-02-06
1295241891 Rachel Sims Nurse Practitioner 8408 Nw 143rd Ter, Oklahoma City, OK 73142-7002 2017-12-18
1417475997 Tola Janet Suleiman Nurse Practitioner 13024 Almond Dr, Oklahoma City, OK 73170-1152 2017-09-05
1477073609 Mary Ann Hayden Nurse Practitioner 3224 Sw 119th Street, Hennessee & Associates, Oklahoma City, OK 73170 2017-06-20
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Competitor

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City OKLAHOMA CITY
Zip Code 73112

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Dataset Information

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.

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