FAIRFAX MEDICAL FACILITIES INC (NPI# 1538183173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538183173 |
| Entity Type | Organization |
| Organization Name | FAIRFAX MEDICAL FACILITIES INC |
| Other Organization Name | ROBERT CLARK FAMILY HEALTH CENTER |
| Practice Address |
212 N Main St Fairfax OK 74637-3023 |
| Practice Telephone | 9186423100 |
| Practice Fax Number | 9186425639 |
| Mailing Telephone | 9186423100 |
| Mailing Fax Number | 9186425639 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-01-06 |
| Authorized Official Name | MR. KAREN MCCONNELL (CEO) |
| Authorized Official Telephone | 9186423100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200071420D | 05 | |
| OK | 200071420E | 05 | |
| OK | 200071420G | 05 | |
| OK | 200071420F | 05 | |
| OK | 200071420B | 05 |
| Other Name | Type Code |
|---|---|
| Robert Clark Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548609217 | Fairfax Medical Facilities Inc | Clinic/Center | 100 N Hickerson Dr, Cleveland, OK 74020-4003 | 2013-06-17 |
| 1346507266 | Fairfax Medical Facilities Inc | Clinical Nurse Specialist | 100 N Hickerson Dr, Cleveland, OK 74020-4003 | 2012-04-17 |
| 1992092647 | Fairfax Medical Facilities Inc | Clinic/Center | 1717 N 4th St, Ste 102, Ponca City, OK 74601-2748 | 2011-07-01 |
| 1851535785 | Fairfax Medical Facilities Inc | Clinic/Center | 716 S Highway 77, Newkirk, OK 74647-7009 | 2009-04-22 |
| 1316111255 | Fairfax Medical Facilities Inc | Clinic/Center | 212 N Main St, Fairfax, OK 74637-3023 | 2008-04-22 |
| 1609040864 | Fairfax Medical Facilities Inc | Family Medicine | 119 W Main St, Hominy, OK 74035 | 2008-04-18 |
| Street Address |
212 N MAIN ST |
| City | FAIRFAX |
| State | OK |
| Zip Code | 74637-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841274271 | Deanna J. Cummings | Physician Assistant | 212 N Main St, Fairfax, OK 74637-3023 | 2005-11-30 |
| 1336382217 | Shelley G Simon | Social Worker | 212 N Main St, Fairfax, OK 74637-3023 | 2009-04-08 |
| 1316111255 | Fairfax Medical Facilities Inc | Clinic/Center | 212 N Main St, Fairfax, OK 74637-3023 | 2008-04-22 |
| 1023138195 | Leslie C Christopher | Dentist | 212 N Main St, Fairfax, OK 74637-3023 | 2007-03-30 |
| 1932296209 | Rebecca A Rhodes | Nurse Practitioner | 212 N Main St, Fairfax, OK 74637-3023 | 2006-10-06 |
| 1770593600 | Paul Francis Ley Jr. | Obstetrics & Gynecology | 212 N Main St, Fairfax, OK 74637-3023 | 2006-08-09 |
| 1043226764 | James I Graham | Family Medicine | 212 N Main St, Fairfax, OK 74637-3023 | 2006-08-01 |
| 1619941754 | Neal Ross Brockbank | Family Medicine | 212 N Main St, Fairfax, OK 74637-3023 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588725485 | Michael S Ben Inc PC | Dentist | 161 N 2nd Street, Fairfax, OK 74637 | 2006-12-13 |
| 1306145339 | Cah Acquisition Company 12 LLC | Clinic/Center | 40 Hospital Rd, Fairfax, OK 74637 | 2011-03-16 |
| 1134451396 | Cah Acquisition Company 12 LLC | Medicare Defined Swing Bed Unit | 40 Hospital Rd, Fairfax, OK 74637 | 2010-02-12 |
| 1376554006 | Fairfax Healthcare Properties,llc | General Acute Care Hospital | Hwy 18 & Taft Avenue, Fairfax, OK 74637-0219 | 2006-08-10 |
| 1922143098 | Fairfax Healthcare Properties,l.l.c. | Medicare Defined Swing Bed Unit | Hwy 18 & Taft Avenue, Fairfax, OK 74637-0219 | 2007-02-20 |
| 1679613970 | Elmer Gari Owens | Physician Assistant | Hwy 18 & Taft Avenue, Fairfax, OK 74637-0219 | 2007-02-07 |
| 1861502635 | Madison Medical LLC | Durable Medical Equipment & Medical Supplies | 115 W. Maple, Fairfax, OK 74637-1533 | 2006-08-30 |
| 1962911123 | Oklahoma Advantage Storehouse, LLC | Durable Medical Equipment & Medical Supplies | 403 N Main St, Fairfax, OK 74637-1547 | 2017-09-20 |
| 1780853382 | Wanda W Priddy | Social Worker | 301 N 2nd St, Fairfax, OK 74637-2012 | 2008-02-27 |
| 1689628711 | Jean M Helmbright | Psychiatry & Neurology | 301 N 2nd St, Fairfax, OK 74637-2012 | 2006-05-22 |
| Find all providers in zip 74637 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1649366022 | Low Country Health Care System, Inc | Clinic/Center | 333 Revoluntionary Trail, Fairfax, SC 29827-7109 | 2006-10-05 |
| 1154988269 | Neighborhood Health | Clinic/Center | 8221 Willow Oaks Corporate Dr Ste 450, Fairfax, VA 22031-4512 | 2019-05-23 |
| 1003354416 | Neighborhood Health | Clinic/Center | 8221 Willow Oaks Corporate Dr, Fairfax, VA 22031-4512 | 2017-02-06 |
| 1164971495 | The Richford Health Center Inc | Clinic/Center | 1199 Main St, Fairfax, VT 05454-9530 | 2016-09-28 |
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| 1184286726 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 302 W Smith Street, Stratford, OK 74872-4648 | 2019-07-03 |
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| 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.