FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC (NPI# 1174830665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174830665 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC |
| Practice Address |
107 E Post Ave Coalgate OK 74538-3004 |
| Mailing Address |
610 E 24th St Tishomingo OK 73460-3245 |
| Practice Telephone | 5809272828 |
| Practice Fax Number | 5809279876 |
| Mailing Telephone | 5803712343 |
| Mailing Fax Number | 5803712451 |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | MICHELLE L ORR (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5803712343 |
| Is Organization Subpart | Y |
| Parent Organization Name | FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OK | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982267910 | Family Health Center of Southern Oklahoma Inc | Clinic/Center | 21 N Main St, Kingston, OK 73439-6562 | 2019-04-16 |
| 1598803942 | Family Health Center of Southern Oklahoma Inc | Clinic/Center | 610 E 24th St, Tishomingo, OK 73460-3245 | 2007-02-01 |
| Street Address |
107 E POST AVE |
| City | COALGATE |
| State | OK |
| Zip Code | 74538-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518068501 | David L Fisher | Physician Assistant | 107 E Post Ave, Coalgate, OK 74538-3004 | 2006-09-25 |
| 1447471255 | Michael Dell Hendrix | Family Medicine | 107 E Post Ave, Coalgate, OK 74538-3001 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982825758 | Regina Baker | Lodging | 205 W Cedar, Coalgate, OK 74538 | 2007-05-01 |
| 1447478763 | Tracy Mowdy Penney | Speech-Language Pathologist | Coal County General Hospital, Pt Dept, 6 North Covington, Coalgate, OK 74538 | 2007-04-23 |
| 1972679074 | Coalgate Dental Clinic PC | Dentist | 405 W Clay, Coalgate, OK 74538 | 2006-11-28 |
| 1609847573 | Cottonwood Public School | Public Health or Welfare | Lubbis St, 2 Mi Ne of Coalgate Ok On State Hwy 31, Cottonwood, OK 74538-0347 | 2006-01-30 |
| 1578603577 | Coalgate Public School | Local Education Agency (LEA) | 3 West Cedar, Coalgate, OK 74538-0368 | 2007-02-07 |
| 1609359181 | Jamie Niccole Smith | Case Manager/Care Coordinator | 709 S Arno St, Coalgate, OK 74538-1616 | 2018-09-11 |
| 1063896116 | Justin Farris | Counselor | 404 W Cedar Ave, Coalgate, OK 74538-1813 | 2015-07-17 |
| 1639178130 | Coal County Extended Care Incorporated | Skilled Nursing Facility | 7 N Covington St, Coalgate, OK 74538-2001 | 2005-07-18 |
| 1629077227 | Coal County General Hospital | General Acute Care Hospital | 6 N Covington St, Coalgate, OK 74538-2002 | 2005-07-18 |
| 1730357922 | Coal County General Hospital | Medicare Defined Swing Bed Unit | 6 N Covington St, Coalgate, OK 74538-2002 | 2008-02-11 |
| Find all providers in zip 74538 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.