CENTRAL OKLAHOMA FAMILY MEDICAL CENTER (NPI# 1952569808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952569808 |
| 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 | 2008-05-28 |
| Last Update Date | 2008-05-28 |
| 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 | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100737160Q | 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 |
| 1730347329 | Central Oklahoma Family Medical Center | Respite Care | 527 W 3rd St, Konawa, OK 74849-1415 | 2008-05-30 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487274502 | Horizon Enterprises & Healthcare Services | Day Training, Developmentally Disabled Services | 8740 E 11th St Ste B, Tulsa, OK 74112-7957 | 2020-04-18 |
| 1346766078 | Angels Place | Day Training, Developmentally Disabled Services | 3919 S. Oswego Avenue, Tulsa, OK 74135 | 2017-08-15 |
| 1144671355 | Divine Love Outreach Ministries | Day Training, Developmentally Disabled Services | 500 N F St, Muskogee, OK 74403-4144 | 2016-06-29 |
| 1144687922 | Stillwater Group Homes, Inc. | Day Training, Developmentally Disabled Services | 904 W 11th Ave, Stillwater, OK 74074-5423 | 2016-01-25 |
| 1740600436 | Community Access, Incorporated | Day Training, Developmentally Disabled Services | 1104 Se 36th St, Lawton, OK 73501-8458 | 2014-04-21 |
| 1144642885 | Oasis of Love Inc. | Day Training, Developmentally Disabled Services | 16811 E 31st St, Tulsa, OK 74134-5102 | 2014-01-15 |
| 1043649734 | Lashawn Denise Baker | Day Training, Developmentally Disabled Services | 4961 S 76th East Ave, Tulsa, OK 74145-6628 | 2013-11-04 |
| 1952639643 | Jhl Enterprises | Day Training, Developmentally Disabled Services | 102 Willow Spring Cir, Pauls Valley, OK 73075-5316 | 2009-11-18 |
| 1306013008 | Special Young Adults, Inc. | Day Training, Developmentally Disabled Services | 826 W Oregon Ave, Chickasha, OK 73018-4423 | 2008-05-12 |
| 1487823290 | Chickasha Opportunity Center, Inc. | Day Training, Developmentally Disabled Services | 1804 W Iowa Ave, Chickasha, OK 73018-2707 | 2008-02-26 |
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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.