ST. MADRON MEDICAL CLINIC (NPI# 1285068791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285068791 |
| Entity Type | Organization |
| Organization Name | ST. MADRON MEDICAL CLINIC |
| Other Organization Name | WELLNESS CLINIC OF ROLAND INC |
| Practice Address |
205 E. Ray Fine Blvd St. 6 Roland OK 74954 |
| Mailing Address |
303 Towson Ave. Fort Smith AR 72901 |
| Practice Telephone | 9185036235 |
| Practice Fax Number | 9183980637 |
| Mailing Telephone | 9185036235 |
| Mailing Fax Number | 9183980637 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2015-08-06 |
| Authorized Official Name | DARREN BREWER (OWNER) |
| Authorized Official Telephone | 9185036235 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 17754 | OK | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Wellness Clinic of Roland Inc | Former Legal Business Name - Organization |
| Street Address |
205 E. RAY FINE BLVD ST. 6 |
| City | ROLAND |
| State | OK |
| Zip Code | 74954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164969887 | Trinka Blankenship | Case Manager/Care Coordinator | 509 Dewey St, Poteau, OK 74954 | 2017-01-20 |
| 1972959625 | Karen Lynn Williams | Nurse Practitioner | 508 W. Ray Fine Blvd, Roland, OK 74954 | 2016-05-12 |
| 1316178155 | Kimberley Ann Brunk | Optometrist | 1022 East Ray Fine Boulevard Suite 5, Roland, OK 74954 | 2009-07-28 |
| 1891939765 | Gary L Axley | Acupuncturist | 303 E. Ray Fine Blvd, Ste 3, Roland, OK 74954 | 2009-04-23 |
| 1598944944 | Seubold Family Chiropractic Inc | Chiropractor | 311 4 E Ray Fine Blvd, Suite4, Roland, OK 74954 | 2007-11-01 |
| 1689799793 | Cynthia Carol Almond | Preventive Medicine | 309 East Ray Fine Blvd, Roland, OK 74954 | 2007-03-20 |
| 1457498644 | Robert Kale | Anesthesiology | 100 East Ray Fine Blvd., Suite Q, Roland, OK 74954 | 2007-01-30 |
| 1255491494 | Lequita J. Joyce Inc | Counselor | 100 East Ray Fine Blvd, Roland, OK 74954 | 2006-12-11 |
| 1174604268 | Morgan A Seubold | Chiropractor | 1022 E Ray Fine Blvd, Ste 4, Roland, OK 74954 | 2006-10-17 |
| 1265542617 | Sequoyah East Nursing Center LLC | Skilled Nursing Facility | 701 S Taylor Rd, Roland, OK 74954 | 2006-08-30 |
| Find all providers in zip 74954 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497756076 | Dario M Espina | Specialist | 205 E Ray Fine Blvd Ste 6, Roland, OK 74954-5381 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244317 | Hannah Robinette | Specialist | 1822 N Perkins Rd Apt 1535, Stillwater, OK 74075-3138 | 2020-10-28 |
| 1962001453 | Chantelle Nicole Craig | Specialist | 515 S Hafner St, Stillwater, OK 74074-3980 | 2020-10-26 |
| 1073131496 | Ginger Dawn Weber | Specialist | 1431 Hite Blvd, Enid, OK 73703-7938 | 2020-07-13 |
| 1558993568 | Ihelpc LLC | Specialist | 913 N Roosevelt Ave, Sand Springs, OK 74063-7329 | 2020-02-07 |
| 1467092924 | Gabrielle Mae Fielstra | Specialist | 1711 S 77th East Ave, Tulsa, OK 74112-7817 | 2020-01-13 |
| 1821649146 | Stacie Garrett | Specialist | 15487 State Highway 17, Fletcher, OK 73541-4011 | 2019-09-27 |
| 1992355994 | Heaven Lax | Specialist | 1229 Live Oak St, Muskogee, OK 74403-2542 | 2019-09-12 |
| 1295383289 | Keto Wellness and Hormone Clinic | Specialist | 900 N Porter Ave Ste 212, Norman, OK 73071-6485 | 2019-09-03 |
| 1932634789 | Suboxone Solutions LLC | Specialist | 10813 N Macarthur Blvd Ste W, Oklahoma City, OK 73162-6904 | 2017-04-28 |
| 1538609037 | Melissa Lanier | Specialist | 801 N. Louisa, Shawnee, OK 74801 | 2017-03-02 |
| 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.