Active NPI
Monduta Healthcare Services LLC
- Health Service Clinic/Center
- Wagoner, OK
National Provider Identifier
1023804424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- MONDUTA HEALTHCARE SERVICES LLC
- Doing business as
- Dunamis Complete Health
- Practice address
- 1202 W Cherokee St Ste C
Wagoner, OK 74467-4629 - Phone
- (918) 857-9932
- NPI assigned
- Apr 15, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ernest Maina, NP
- Title
- Owner
- Phone
- (918) 857-9932
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Primary |
Addresses
Primary practice location
1202 W Cherokee St Ste C
Wagoner, OK 74467-4629
Mailing address
1000 W Elmira St
Broken Arrow, OK 74012-0872
Phone (918) 857-9932
Other names 2
- Dunamis Complete Health
- MONDUTA HEALTHCARE SERVICES LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1202 W Cherokee St
Wagoner, OK 74467
Phone (918) 485-4504
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Wagoner, OK
- NPI 1740751445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769731200000",
"number": "1023804424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 W ELMIRA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740120872",
"telephone_number": "918-857-9932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 W CHEROKEE ST STE C",
"city": "WAGONER",
"state": "OK",
"postal_code": "744674629",
"telephone_number": "918-857-9932"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONDUTA HEALTHCARE SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-15",
"last_updated": "2026-01-30",
"certification_date": "2026-01-30",
"status": "A",
"authorized_official_last_name": "MAINA",
"authorized_official_first_name": "ERNEST",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-857-9932",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dunamis Complete Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "MONDUTA HEALTHCARE SERVICES LLC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Wagoner, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.