CENTRAL OKLAHOMA FAMILY MEDICAL CENTER (NPI# 1659530780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659530780 |
| Entity Type | Organization |
| Organization Name | CENTRAL OKLAHOMA FAMILY MEDICAL CENTER |
| Practice Address |
527 W 3rd St Konawa OK 74849-1415 |
| Practice Telephone | 5809253286 |
| Practice Fax Number | 5809252362 |
| Mailing Telephone | 5809253286 |
| Mailing Fax Number | 5809252362 |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |
| Authorized Official Name | CASEY HAROLD ANSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5809253286 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | OK | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100737160R | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598911752 | Central Oklahoma Family Medical Center | Clinic/Center | Nbu 1706 Highway 99 South, Prague, OK 74864 | 2008-08-07 |
| 1215196340 | Central Oklahoma Family Medical Center | Residential Treatment Facility, Emotionally Disturbed Children | 527 W 3rd St, Konawa, OK 74849-1415 | 2008-06-04 |
| 1407015530 | Central Oklahoma Family Medical Center | Registered Nurse | 527 W 3rd St, Konawa, OK 74849-1415 | 2008-06-04 |
| 1730347329 | Central Oklahoma Family Medical Center | Respite Care | 527 W 3rd St, Konawa, OK 74849-1415 | 2008-05-30 |
| 1952569808 | Central Oklahoma Family Medical Center | Day Training, Developmentally Disabled Services | 527 W 3rd St, Konawa, OK 74849-1415 | 2008-05-28 |
| 1306973094 | Central Oklahoma Family Medical Center | Clinic/Center | 527 W 3rd St, Konawa, OK 74849-1415 | 2007-02-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTRAL OKLAHOMA FAMILY MEDICAL CENTER | 527 W 3rd, Konawa, OK 74849-1415 |
| Street Address |
527 W 3RD ST |
| City | KONAWA |
| State | OK |
| Zip Code | 74849-1415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962407999 | Judy Pearce | Nurse Practitioner | 527 W 3rd St, Konawa, OK 74849-1415 | 2005-06-16 |
| 1366049280 | Kelsey Katherine Hartman | Physician Assistant | 527 W 3rd St, Konawa, OK 74849-1415 | 2020-10-04 |
| 1548886831 | Kelli Lowry | Speech-Language Pathologist | 527 W 3rd St, Konawa, OK 74849-1415 | 2020-06-22 |
| 1407414295 | Roberto Bonilla Gallegos | Case Manager/Care Coordinator | 527 W 3rd St, Konawa, OK 74849-1415 | 2019-06-05 |
| 1750882775 | Amanda Lynn Cubit | Nurse Practitioner | 527 W 3rd St, Konawa, OK 74849-1415 | 2018-02-25 |
| 1376061127 | Cari Renee Gravel | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2017-08-31 |
| 1235659418 | Marilyn Kay Dixon | Case Manager/Care Coordinator | 527 W 3rd St, Konawa, OK 74849-1415 | 2017-06-20 |
| 1881067502 | Paige Vandegrift | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2015-11-03 |
| 1285013540 | Central Oklahoma Family Medical Center, Inc | Specialist | 527 W 3rd St, Konawa, OK 74849-1415 | 2015-05-20 |
| 1255767372 | Lindsey Clark | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2013-09-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680176 | Dave Garrett Herriman | Social Worker | 527 W Third Street, Konawa, OK 74849 | 2014-04-22 |
| 1518152529 | Tami Ranae Hernandez | Counselor | 527 West Third St, Konawa, OK 74849 | 2007-09-12 |
| 1427067859 | Erron Cody Proctor | Physician Assistant | 527 West 3rd St, Konawa, OK 74849 | 2006-08-05 |
| 1972519544 | Umar Saeed | Family Medicine | 527 West Third Street, Konawa, OK 74849 | 2006-08-01 |
| 1831291293 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 527 West 3rd St, Konawa, OK 74849 | 2006-09-05 |
| 1972725828 | Larna Louise Tribbey | Counselor | 527 West Third Street, Konawa, OK 74849-0000 | 2007-05-02 |
| 1104315829 | Konawa Public Schools | Local Education Agency (LEA) | 701 W South St, Konawa, OK 74849-1417 | 2018-05-08 |
| 1932482957 | Doris Chance | Case Manager/Care Coordinator | 308 W 4th St, Konawa, OK 74849-1612 | 2011-09-26 |
| 1922137314 | Cbw Inc | Intermediate Care Facility, Mental Illness | 308 W 4th St, Konawa, OK 74849-1612 | 2007-03-03 |
| 1255538237 | Gayla Carter | Counselor | 316 N East St, Konawa, OK 74849-1802 | 2007-07-02 |
| Find all providers in zip 74849 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618758 | Jonathan Nyanquoi Nyanyoun | Case Management | 12508 E 34th St, Tulsa, OK 74146-2218 | 2020-10-30 |
| 1437758323 | Free Your Mind Counseling | Case Management | 10802 Quail Plaza Dr Ste 208, Oklahoma City, OK 73120-3121 | 2020-10-21 |
| 1750997680 | Vanessa Flores | Case Management | 13177 Ne Tony Creek Rd, Elgin, OK 73538-2006 | 2020-09-16 |
| 1619588134 | Coral LLC | Case Management | 12352 Market Dr, Oklahoma City, OK 73114-8136 | 2020-08-10 |
| 1003430497 | Meals On Wheels of Metro Tulsa, Inc. | Case Management | 12620 E 31st St, Tulsa, OK 74146-2307 | 2020-06-02 |
| 1972137107 | Delayna Lynne Marion | Case Management | 109902 S 4570 Rd, Sallisaw, OK 74955-5086 | 2020-02-26 |
| 1649802679 | Amee Renae Brown | Case Management | 9225 E 570 Rd, Kansas, OK 74347-1620 | 2020-02-07 |
| 1780223453 | 20th District Drug Court | Case Management | 39 N Washington St Ste 219, Ardmore, OK 73401-7056 | 2019-12-30 |
| 1528629813 | Medefy Health LLC | Case Management | 8596 E 101st St Ste C, Tulsa, OK 74133-7037 | 2019-06-26 |
| 1033778287 | Sheena M Spies | Case Management | 816 W Oakland St, Broken Arrow, OK 74012-1662 | 2019-06-11 |
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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.