FIRST MED CLINIC 39TH LLC (NPI# 1477992055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477992055 |
| Entity Type | Organization |
| Organization Name | FIRST MED CLINIC 39TH LLC |
| Practice Address |
4510 Nw 39th St Oklahoma City OK 73122-2503 |
| Mailing Address |
1221 N Kelly Ave Edmond OK 73003-4865 |
| Practice Telephone | 4054955841 |
| Practice Fax Number | 4054957825 |
| Mailing Telephone | 4054716400 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |
| Authorized Official Name | TODD LECHTENBERGER (CEO) |
| Authorized Official Telephone | 4054716400 |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANCE PHYSICIANS GROUP LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4510 NW 39TH ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73122-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114027927 | Bruce D Thompson | General Practice | 4510 Nw 39th St, Oklahoma City, OK 73122-2503 | 2006-09-22 |
| 1790195568 | Advance Physicians Group | Clinic/Center | 4510 Nw 39th St, Oklahoma City, OK 73122-2503 | 2014-05-02 |
| 1083945992 | Elizabeth Arlana Varney | Physician Assistant | 4510 Nw 39th St, Oklahoma City, OK 73122-2503 | 2010-01-18 |
| 1063672608 | Samuel Brandon Hancock | Radiology | 4510 Nw 39th St, Oklahoma City, OK 73122-2503 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765959 | Cullen Crawford | Behavior Technician | 4704 Nw 40th, Oklahoma City, OK 73122 | 2020-03-13 |
| 1700446259 | T&r Services, Inc. | In Home Supportive Care | 3844 N. Macarthur Blvd, Warr Acres, OK 73122 | 2019-06-17 |
| 1962997072 | Stephen Vaughn Johnson | Case Management | 5910 Nw 58th Steet, Oklahoma City, OK 73122 | 2018-06-30 |
| 1598279374 | Sikirat Iyanda | Case Manager/Care Coordinator | 5317 Willow Cliff Rd Apt 137, Okc, OK 73122 | 2017-11-30 |
| 1841650827 | Victoria Ekwueme | Counselor | 6421 Nw 36th Street, Oklahoma City, OK 73122 | 2016-03-03 |
| 1861760837 | John Bernard Gilleran | Anesthesiology | 4940 Nw 31st St, Oklahoma City, OK 73122 | 2011-12-06 |
| 1356623482 | Jerry Skariah George | Pharmacist | 5901 Nw 39th Expressway, Warr Acres, OK 73122 | 2011-09-14 |
| 1306134366 | Chelsea Nicole Haller | Physical Therapist | 5604 N.w. 41st, Suite 220, Oklahoma City, OK 73122 | 2011-07-12 |
| 1972824886 | Katrina Renee Klohn | Counselor | 5612 Nw 62nd St., Okc, OK 73122 | 2010-06-15 |
| 1205039377 | Larry L Winnard | Specialist/Technologist | 5300 N. W. 50th, Okla. City, OK 73122 | 2007-06-07 |
| Find all providers in zip 73122 | ||||
| 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 |
|---|---|---|---|---|
| 1164039632 | Axiom Medical Solutions, LLC | Family Medicine | 14132 Se 134th St, Oklahoma City, OK 73165-7669 | 2020-09-28 |
| 1104437219 | L and M Investments LLC | Family Medicine | 6001 Nw 139th St, Oklahoma City, OK 73142-1919 | 2020-08-12 |
| 1235748617 | Brook Noel Leland | Family Medicine | 3329 Nw 22nd St, Oklahoma City, OK 73107-3021 | 2020-07-30 |
| 1043835176 | Thomas Patrick Owens IIi | Family Medicine | 900 Ne 10th Street, Oklahoma City, OK 73104-5420 | 2020-06-15 |
| 1730703562 | Michael Williamson | Family Medicine | 3500 Nw 56th St Ste 10, Oklahoma City, OK 73112-4529 | 2020-06-08 |
| 1295363620 | Saint Medical Group, LLC | Family Medicine | 3400 S Douglas Blvd Ste 307, Oklahoma City, OK 73150-1001 | 2020-03-31 |
| 1881220580 | Sarah Laing | Family Medicine | 1111 N Lee Ave Ste 305, Oklahoma City, OK 73103-2620 | 2020-03-14 |
| 1881225290 | Neans Lynn Denson | Family Medicine | 2815 Sw 119th St, Oklahoma City, OK 73170-2605 | 2020-02-04 |
| 1114563699 | Aim Health Clinics, LLC | Family Medicine | 2301 W I 44 Service Rd Ste 310, Oklahoma City, OK 73112-8729 | 2019-11-20 |
| 1841843265 | Stephanie N White | Family Medicine | 3400 Nw Expressway Bldg C-815, Oklahoma City, OK 73112-4493 | 2019-07-24 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73122 |
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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.