PUSHMATAHA FAMILY MEDICAL CENTER INC (NPI# 1487193819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487193819 |
| Entity Type | Organization |
| Organization Name | PUSHMATAHA FAMILY MEDICAL CENTER INC |
| Other Organization Name | PUSHMATAHA FAMILY MEDICAL CENTER OF BOSWELL |
| Practice Address |
415 6th Street Boswell OK 74727-0149 |
| Mailing Address |
Po Box 219 Clayton OK 74536-0219 |
| Practice Telephone | 5805662530 |
| Practice Fax Number | 5805662533 |
| Mailing Telephone | 9185694143 |
| Mailing Fax Number | 9185697552 |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |
| Authorized Official Name | ANGELA R BATTON (CEO) |
| Authorized Official Telephone | 9185694143 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | PUSHMATAHA FAMILY MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200072150E | 05 |
| Other Name | Type Code |
|---|---|
| Pushmataha Family Medical Center of Boswell | Doing Business As Name - Organization |
| Street Address |
415 6TH STREET |
| City | BOSWELL |
| State | OK |
| Zip Code | 74727-0149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528430998 | Amanda Lyn Vandenburg | Nurse Practitioner | 415 6th Street, Boswell, OK 74727-0000 | 2015-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710372545 | Julie Palmer | Speech-Language Pathologist | 604 7th St, Boswell, OK 74727 | 2015-03-30 |
| 1407100704 | Chad Eric Austin | Counselor | 701 East Hunter Avenue, Boswell, OK 74727-0254 | 2012-11-08 |
| 1083657753 | Amelia Gayle Lee | Durable Medical Equipment & Medical Supplies | 530 Hunter Ave, Boswell, OK 74727-0275 | 2006-06-13 |
| 1972710093 | Boswell Public Schools | Physical Therapist | 604 N 7th St, Boswell, OK 74727-0839 | 2007-05-17 |
| 1881041879 | Paige Percer | Obstetrics & Gynecology | Rr 1 Box 835, Boswell, OK 74727-9726 | 2016-05-19 |
| 1871921403 | Ashley Smallwood | Counselor | Rr 1 Box 2120, Boswell, OK 74727-9736 | 2013-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367421 | Kathryn Ann Schmitz | Counselor | 140 Odyssey Dr, Boswell, PA 15531-1834 | 2020-05-12 |
| 1881041879 | Paige Percer | Obstetrics & Gynecology | Rr 1 Box 835, Boswell, OK 74727-9726 | 2016-05-19 |
| 1962875419 | Janice Baker | Registered Nurse | 1004 Morris Ave, Boswell, PA 15531-1004 | 2015-11-05 |
| 1871921403 | Ashley Smallwood | Counselor | Rr 1 Box 2120, Boswell, OK 74727-9736 | 2013-10-16 |
| 1316386113 | Gibson Furniture Inc | Durable Medical Equipment & Medical Supplies | 407 N Old Us Highway 41, Boswell, IN 47921-8512 | 2013-06-14 |
| 1407100704 | Chad Eric Austin | Counselor | 701 East Hunter Avenue, Boswell, OK 74727-0254 | 2012-11-08 |
| 1861746265 | Lori-anne Catherine Maurer | Counselor | 132 Tipton Rd, Boswell, PA 15531-2821 | 2012-11-07 |
| 1811293061 | Nathan David Lehman | Nurse Anesthetist, Certified Registered | 968 N Fork Dam Rd, Boswell, PA 15531-1826 | 2011-02-07 |
| 1487843579 | Total Mobility Services, Inc. | Durable Medical Equipment & Medical Supplies | 4785 Penn Ave, Boswell, PA 15531-0007 | 2007-10-15 |
| 1396930475 | Misty C Toro | Nurse Practitioner | 430 Stonycreek St, Boswell, PA 15531-1024 | 2007-09-11 |
| Find all providers in BOSWELL | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1265902589 | Community Health Center of Northeast Oklahoma | Clinic/Center | 244 S Scraper Suite D, Vinita, OK 74301-3716 | 2018-11-29 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1306352547 | Variety Care, Inc. | Clinic/Center | 721 W Britton Rd, Oklahoma City, OK 73114-2909 | 2017-12-26 |
| 1568976991 | Arkansas Verdigris Valley Health Centers,inc. | Clinic/Center | 201 North 32nd Street, Muskogee, OK 74401-2104 | 2017-11-21 |
| 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.