SOUTHERN PLAINS MEDICAL CENTER INC (NPI# 1477101715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477101715 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PLAINS MEDICAL CENTER INC |
| Practice Address |
100 Valley Dr Pauls Valley OK 73075-6613 |
| Mailing Address |
2222 W Iowa Ave Chickasha OK 73018-2738 |
| Practice Telephone | 4058253707 |
| Mailing Telephone | 4058253707 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |
| Authorized Official Name | LEN LACEFIELD (CEO) |
| Authorized Official Telephone | 4054546058 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN PLAINS MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Urgent Care & Diagnostic Center of Pauls Valley | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336767383 | Southern Plains Medical Center Inc | Dermatology | 9 N Bryant Ave, Edmond, OK 73034-6307 | 2020-07-07 |
| 1669413662 | Southern Plains Medical Center Inc | Clinic/Center | 2222 W Iowa Ave, Chickasha, OK 73018-2738 | 2006-06-09 |
| Street Address |
100 VALLEY DR |
| City | PAULS VALLEY |
| State | OK |
| Zip Code | 73075-6613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629074992 | Tammy Kay Jarvis | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2005-06-22 |
| 1457711731 | Woven Emergency Physicians, LLC | Physician Assistant | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2016-03-01 |
| 1275865982 | Pauls Valley General Hospital | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075 | 2010-02-04 |
| 1275861163 | John Michael Teel | Pharmacist | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2009-12-03 |
| 1033353206 | Abdulwali Samad Rahimi | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2009-04-30 |
| 1790933182 | Huma Naz | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2008-08-28 |
| 1841458387 | Satti Fageri Nasr Bilal | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2008-05-31 |
| 1811055288 | Laurence Arnold Heineman | Emergency Medicine | 100 Valley Dr, Emergency Department, Pauls Valley, OK 73075-6613 | 2006-12-05 |
| 1659447324 | Ann Hull | Pharmacist | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2006-11-27 |
| 1013083906 | Pauls Valley General Hospital | General Acute Care Hospital | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2006-11-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292490 | Jennifer Lynn Reicosky | Counselor | 513 Willow, Pauls Valley, OK 73075 | 2018-10-25 |
| 1336467299 | Fred Lee Mcginn Iv | Counselor | Atlc, 111 Arrowhead Dr., Pauls Valley, OK 73075 | 2010-05-17 |
| 1447435433 | Amanda Marie Hammonds | Physical Therapist | 37915 Ecr 1530, Pauls Valley, OK 73075 | 2008-01-08 |
| 1255533873 | Ladonna L.l. Lynnell Luckey | Counselor | 111 Arrowhead Drive, Adolescent Transitional Living Center, Pauls Valley, OK 73075 | 2007-06-05 |
| 1144369026 | James Ray Ward | Dentist | 112 N Oak, Pauls Valley, OK 73075 | 2007-02-06 |
| 1700953247 | Stanley Family Chiropractic PC | Chiropractor | 1555 W Grant, Pauls Valley, OK 73075 | 2006-11-29 |
| 1659458412 | Woodlawn, LLC | Respite Care | 1413 S. Chickasha, Pauls Valley, OK 73075 | 2006-11-01 |
| 1689750457 | Dana J Martin Dds PC | Dentist | 1600 Airline Road, Pauls Valley, OK 73075 | 2006-10-27 |
| 1609963800 | State of Oklahoma Dept. of Human Services | Pharmacy | Rt 1 Box 44a, Pauls Valley, OK 73075 | 2006-10-07 |
| 1295828895 | State of Oklahoma Dept. of Human Services | Intermediate Care Facility, Mentally Retarded | Rt. 1 Box 44-a, Pauls Valley, OK 73075 | 2006-10-02 |
| Find all providers in zip 73075 | ||||
| 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 |
|---|---|---|---|---|
| 1306956156 | Dennis Ray Whitehouse Do | Family Medicine | 415 W Guy Ave, Pauls Valley, OK 73075-3200 | 2006-08-30 |
| 1952340572 | Brian A Allee | Family Medicine | 105 N Indian Meridian Rd, Pauls Valley, OK 73075-9236 | 2006-06-06 |
| 1134189798 | Charles K Jones | Family Medicine | 1200 S Walnut St, Pauls Valley, OK 73075 | 2006-03-27 |
| 1629074992 | Tammy Kay Jarvis | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2005-06-22 |
| 1407328032 | Southern Plains Medical Center, Inc | Family Medicine | 106 Burr Ave, Pauls Valley, OK 73075-3848 | 2018-12-20 |
| 1215406103 | Southern Plains Medical Center, Inc | Family Medicine | 101 N Carter St, Pauls Valley, OK 73075-9811 | 2018-11-20 |
| 1275865982 | Pauls Valley General Hospital | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075 | 2010-02-04 |
| 1922338326 | Dennis Whitehouse Inc | Family Medicine | 415 W Guy Ave, Pauls Valley, OK 73075-3200 | 2010-01-06 |
| 1033353206 | Abdulwali Samad Rahimi | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2009-04-30 |
| 1790933182 | Huma Naz | Family Medicine | 100 Valley Dr, Pauls Valley, OK 73075-6613 | 2008-08-28 |
| Find all providers in PAULS VALLEY | ||||
| City | PAULS VALLEY |
| Zip Code | 73075 |
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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.