CENTRAL OK FAMILY MED CTR (NPI# 1720290539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720290539 |
| Entity Type | Organization |
| Organization Name | CENTRAL OK FAMILY MED CTR |
| Other Organization Name | COFMC PRAGUE |
| Practice Address |
Rt 1 Box 85a Prague OK 74864 |
| Mailing Address |
Po Box 358 527 W 3rd St Konawa OK 74849 |
| Practice Telephone | 4055670054 |
| Practice Fax Number | 4055670087 |
| Mailing Telephone | 5809253286 |
| Mailing Fax Number | 5809252362 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CASEY H ANSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5809258819 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| COFMC Prague | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194937904 | Central Ok Family Med Ctr | Clinic/Center | 303 72nd Se, Noble, OK 73068 | 2007-05-04 |
| 1649485996 | Central Ok Family Med Ctr | Clinic/Center | 527 W 3rd St, Konawa, OK 74849 | 2007-05-11 |
| Street Address |
RT 1 BOX 85A |
| City | PRAGUE |
| State | OK |
| Zip Code | 74864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275093098 | Bristow Endeavor Healthcare, LLC | Family Medicine | 1005 Mitacek Ave, Prague, OK 74864 | 2019-03-20 |
| 1699186817 | Helping Hands Home Care, Pllc | Case Management | 517 Jim Thorpe Blvd, Prague, OK 74864 | 2014-05-09 |
| 1386077121 | Jennifer Cook | Case Manager/Care Coordinator | 971 South Jim Thorpe Blvd, Prague, OK 74864 | 2013-08-15 |
| 1104103316 | Syretta Nikia Pittman | Case Manager/Care Coordinator | 1021 South Jim Thorpe Blvd, Prague, OK 74864 | 2011-11-16 |
| 1891009312 | Chasitee Qwinette Burdine | Contractor | 57533 Moccasin Trail Rd, Prague, OK 74864 | 2010-07-27 |
| 1689908261 | Charles Albert Cashman | Dentist | 1201 Jim Thorpe, Suite One, Prague, OK 74864 | 2009-09-29 |
| 1598911752 | Central Oklahoma Family Medical Center | Clinic/Center | Nbu 1706 Highway 99 South, Prague, OK 74864 | 2008-08-07 |
| 1679746234 | Mark Allen White | Counselor | 1025 Meadowbrook Ave, Prague, OK 74864 | 2008-04-03 |
| 1770751752 | Mary Ann Ward | Physician Assistant | 1322 Klabzuba Avenue, Prague, OK 74864 | 2008-02-13 |
| 1487837167 | Land of Hope | Community/Behavioral Health | 57523 Moccasin Trail Road, Prague, OK 74864 | 2007-12-17 |
| Find all providers in zip 74864 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598911752 | Central Oklahoma Family Medical Center | Clinic/Center | Nbu 1706 Highway 99 South, Prague, OK 74864 | 2008-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870742 | Sequelcare of Oklahoma, LLC | Clinic/Center | 6218 S Lewis Ave Ste 118, Tulsa, OK 74136-1018 | 2020-10-28 |
| 1649870890 | M & M Counseling Group, LLC | Clinic/Center | 207 S Czech Hall Rd, Yukon, OK 73099-6851 | 2020-10-27 |
| 1992303721 | Misty Watkins | Clinic/Center | 1601 Sw Parkridge Blvd Ste 200, Lawton, OK 73505-7564 | 2020-10-14 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1235744020 | Strength of A Warrior Counseling Services LLC | Clinic/Center | 4516 Se 25th St, Del City, OK 73115-4114 | 2020-09-09 |
| 1609488253 | Alexie Foster, LLC | Clinic/Center | 16802 S 301st West Ave, Bristow, OK 74010-2265 | 2020-08-17 |
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1649894015 | Miranda Rackers | Clinic/Center | 1308 E Mckinley Ave, Sapulpa, OK 74066-4824 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CENTRAL OK FAMILY MED CTR.
| 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.