CENTRAL OKLAHOMA FAMILY MEDICAL CENTER (NPI# 1730347329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730347329 |
| Entity Type | Organization |
| Organization Name | CENTRAL OKLAHOMA FAMILY MEDICAL CENTER |
| Practice Address |
527 W 3rd St Konawa OK 74849-1415 |
| Practice Telephone | 5809253286 |
| Mailing Telephone | 5809253286 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | MR. CASEY HAROLD ANSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5809253286 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100737160S | 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 |
| 1659530780 | Central Oklahoma Family Medical Center | Case Management | 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 |
| 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 | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144505488 | Life Center, Inc. | Respite Care | 411 W Matthews Ave, Stillwater, OK 74075-7517 | 2011-10-19 |
| 1447429758 | Ultimate Home Care LLC, Dba Oak View Health Services | Respite Care | 2310 S Central, Idabel, OK 74745-7916 | 2008-02-21 |
| 1720263130 | Carrol Lea Stanley IIi | Respite Care | 713 Del Haven Dr, Del City, OK 73115-2907 | 2008-01-03 |
| 1902090251 | Nightingale Nursing Services | Respite Care | 12496 E 26th St, Tulsa, OK 74129-5829 | 2007-08-30 |
| 1134326911 | Brookridge Inc | Respite Care | 7802 Nw Quanah Parker Trailway, Lawton, OK 73505 | 2007-06-27 |
| 1720201403 | Jaunita Marie Simpson | Respite Care | Rr 1 Box 69z, Hastings, OK 73548-9502 | 2007-04-11 |
| 1962525543 | Oasis Adult Day Services | Respite Care | 3817 S Lewis Ave, Tulsa, OK 74105-8219 | 2007-04-09 |
| 1205907631 | Woodlawn, LLC | Respite Care | 2219 Woodlawn Ave, Guthrie, OK 73044-5759 | 2006-11-09 |
| 1659458412 | Woodlawn, LLC | Respite Care | 1413 S. Chickasha, Pauls Valley, OK 73075 | 2006-11-01 |
| 1831437458 | C.a.r.e for Change | Respite Care | 3621 N Kelley Ave, Suite 100, Oklahoma City, OK 73111-4520 | 2013-01-17 |
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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.