BRYANT STREET FAMILY MEDICINE, P.C. (NPI# 1396909446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396909446 |
Entity Type | Organization |
Organization Name | BRYANT STREET FAMILY MEDICINE, P.C. |
Practice Address |
305 South Bryant Ave 110 Edmond OK 73034 |
Practice Telephone | 4055137333 |
Practice Fax Number | 4055137337 |
Mailing Telephone | 4055137333 |
Mailing Fax Number | 4055137337 |
Enumeration Date | 2008-07-17 |
Last Update Date | 2016-11-01 |
Authorized Official Name | DR. CHESCA NICOLE CRAIG-GOODELL (PHYSICIAN) |
Authorized Official Telephone | 4055137333 |
Authorized Official Credential | D.O. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
OK | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | INDIVIDUAL PROVIDER NPI NUMBER | 1366510802 | 01 |
Street Address |
305 SOUTH BRYANT AVE 110 |
City | EDMOND |
State | OK |
Zip Code | 73034 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
Find all providers in zip 73034 |
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 |
1003227414 | Deer Creek Family Healthcare and Wellness Clinic LLC | Clinic/Center | 19401 N. Portland, Edmond, OK 73012 | 2014-05-20 |
1699012435 | Optima Weight & Wellness, LLC | Clinic/Center | 1489 E 15th St, Suite 108, Edmond, OK 73013-5054 | 2013-01-14 |
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 |
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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.