CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC. (NPI# 1831291293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831291293 |
| Entity Type | Organization |
| Organization Name | CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC. |
| Other Organization Name | CENTRAL OKLAHOMA FAMILY MED CENTER |
| Practice Address |
527 West 3rd St Konawa OK 74849 |
| Mailing Address |
527 West 3rd Street Konawa OK 74849 |
| Practice Telephone | 5809253286 |
| Practice Fax Number | 5809252362 |
| Mailing Telephone | 5809253286 |
| Mailing Fax Number | 5809259149 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2019-08-27 |
| Authorized Official Name | BRENDA WARE (CEO) |
| Authorized Official Telephone | 5809253286 |
| Is Organization Subpart | N |
| 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 | 100737160D | 05 |
| Other Name | Type Code |
|---|---|
| Central Oklahoma Family Med Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922571009 | Central Oklahoma Family Medical Center, Inc. | Pharmacy | 905 Colony Dr, Ada, OK 74820 | 2019-01-10 |
| 1154704237 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 1221 Arlington St, Suite B, Ada, OK 74820-4058 | 2015-07-07 |
| 1659708915 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 201 W Main St, Stonewall, OK 74871 | 2013-10-02 |
| 1508952912 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 527 W 3rd St, Konawa, OK 74849-1415 | 2006-10-04 |
| Street Address |
527 WEST 3RD ST |
| City | KONAWA |
| State | OK |
| Zip Code | 74849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427067859 | Erron Cody Proctor | Physician Assistant | 527 West 3rd St, Konawa, OK 74849 | 2006-08-05 |
| 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 |
| 1972519544 | Umar Saeed | Family Medicine | 527 West Third Street, Konawa, OK 74849 | 2006-08-01 |
| 1649485996 | Central Ok Family Med Ctr | Clinic/Center | 527 W 3rd St, Konawa, OK 74849 | 2007-05-11 |
| 1477683860 | Winifred Watson | Social Worker | 527 W 3rd St, Konawa, OK 74849 | 2007-03-06 |
| 1861574717 | Paul Tucker | Social Worker | 527 W 3rd St, Konawa, OK 74849 | 2006-10-19 |
| 1972725828 | Larna Louise Tribbey | Counselor | 527 West Third Street, Konawa, OK 74849-0000 | 2007-05-02 |
| 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 |
| Find all providers in zip 74849 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306973094 | Central Oklahoma Family Medical Center | Clinic/Center | 527 W 3rd St, Konawa, OK 74849-1415 | 2007-02-28 |
| 1508952912 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 527 W 3rd St, Konawa, OK 74849-1415 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404965 | Variety Care, Inc. | Clinic/Center | 201 Ne 50th St Ste 117, Oklahoma City, OK 73105-1811 | 2020-10-13 |
| 1699318550 | Community Health Center of Northeast Oklahoma, Inc. | Clinic/Center | 220 S Mickey Mantle Blvd, Commerce, OK 74339-2924 | 2019-10-23 |
| 1013567940 | Community Health Center of Southeast Kansas, Inc. | Clinic/Center | 7 S 1st St, Wyandotte, OK 74370-2268 | 2019-09-12 |
| 1013569961 | Community Health Connection, Inc. | Clinic/Center | 13702 E 46th Pl, Tulsa, OK 74134-5919 | 2019-07-11 |
| 1184286726 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 302 W Smith Street, Stratford, OK 74872-4648 | 2019-07-03 |
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 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 | ||||
Please comment or provide details below to improve the information on CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC..
| 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.