PUSHMATAHA FAMILY MEDICAL CENTER, INC (NPI# 1891882676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891882676 |
Entity Type | Organization |
Organization Name | PUSHMATAHA FAMILY MEDICAL CENTER, INC |
Practice Address |
109 Stanley Road Clayton OK 74536 |
Mailing Address |
Po Box 219 Clayton OK 74536 |
Practice Telephone | 9185694143 |
Practice Fax Number | 9185697343 |
Mailing Telephone | 9185694143 |
Mailing Fax Number | 9185697343 |
Enumeration Date | 2006-10-05 |
Last Update Date | 2011-02-02 |
Authorized Official Name | ANGELA RENEE BATTON (CEO) |
Authorized Official Telephone | 9185694143 |
Authorized Official Credential | RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OK | Ambulatory Health Care Facilities | |
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | UNIVERSAL DATA SYSTEM | 622460 | 01 |
OK | 200072150B | 05 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oklahoma Business Registrations | PUSHMATAHA FAMILY MEDICAL CENTER, INC. | Po Box 219, Clayton, OK 74536 |
Street Address |
109 STANLEY ROAD |
City | CLAYTON |
State | OK |
Zip Code | 74536 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417043696 | Ernest B Perkins | Physician Assistant | 109 Stanley Road, Clayton, OK 74536 | 2006-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609350057 | Cody Blaine Powell | Chiropractor | 1020 Lawson Blvd, Clayton, OK 74536 | 2018-09-21 |
1598167421 | Aimee Nicole Freeman | Social Worker | 1020 N Lawson Blvd., Clayton, OK 74536 | 2014-09-23 |
1518268762 | Curatio Hospice Inc | Exclusive Provider Organization | 617 North Lawson Street, Clayton, OK 74536 | 2010-11-04 |
1326286717 | Town of Clayton | Ambulance | 221 W. Cherokee Street, Clayton, OK 74536 | 2009-01-23 |
1073525002 | Best Life Rx, LLC | Durable Medical Equipment & Medical Supplies | 536 N Lawson Blvd, Clayton, OK 74536 | 2006-08-11 |
1619941242 | Bob H Womack | Dentist | 109 Stanly Rd, Clayton, OK 74536 | 2006-02-13 |
1669021580 | Christopher Lynn Smith | Nurse Practitioner | 1020 Lawson Blvd, Clayton, OK 74536 | 2019-09-04 |
1275737314 | Clayton Public School | Counselor | 101 Pine Street, Clayton, OK 74536-0190 | 2007-06-13 |
1992306708 | Paula Sue Brown | Nurse Practitioner | 1020 N Lawson Blvd, Clayton, OK 74536-0219 | 2020-11-06 |
1467443309 | Edwin F Ellis | Pediatrics | 1020 N Lawson Boulevard, Clayton, OK 74536-0219 | 2005-10-31 |
Find all providers in zip 74536 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1710048053 | Southeast Alabama Rural Health Associates | Clinic/Center | 7 Western Byp, Clayton, AL 36016-2013 | 2006-12-12 |
1346299807 | Medlink Georgia Inc | Clinic/Center | 896 Highway 441 S, Clayton, GA 30525-5423 | 2006-05-10 |
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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.