Organization Active NPI

Native Wellness LLC

  • Clinic/Center
  • Sulphur, OK
National Provider Identifier
1053287029
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NATIVE WELLNESS LLC
Practice address
1432 W Broadway Ave
Sulphur, OK 73086-4216
Phone
(580) 359-0597
Fax
(580) 203-3241
NPI assigned
Oct 15, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lakrista O'Dell, RNNPI 1427630961
Title
Member / Owner
Phone
(580) 618-1109

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

1432 W Broadway Ave
Sulphur, OK 73086-4216

Mailing address

410 E Tulsa Ave
Sulphur, OK 73086-2845
Phone (580) 359-0597

Other practice location 1

401 S Coltrane Rd Ste 280
Edmond, OK 73034-6722
Phone (580) 359-0597

National Provider Directory

National Provider Directory

Locations

1432 W Broadway Ave
Sulphur, OK 73086
Phone (580) 622-6630

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1053287029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E TULSA AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730862845",
            "telephone_number": "580-359-0597",
            "fax_number": "580-203-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864216",
            "telephone_number": "580-359-0597",
            "fax_number": "580-203-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 S Coltrane Rd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730346722",
            "country_code": "US",
            "telephone_number": "580-359-0597",
            "fax_number": "580-203-3241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "O'DELL",
        "authorized_official_first_name": "LAKRISTA",
        "authorized_official_title_or_position": "MEMBER / OWNER",
        "authorized_official_telephone_number": "580-618-1109",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.