NPIMap

Organization Active NPI

One Cura Family Clinic-Stroud, Inc.

  • Clinic/Center
  • Stroud, OK
National Provider Identifier
1073969358
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ONE CURA FAMILY CLINIC-STROUD, INC.
Practice address
2308B W Highway 66
Stroud, OK 74079-6729
Phone
(714) 745-6191
Fax
(918) 968-4814
NPI assigned
May 5, 2016
Last updated
Apr 13, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ONE CURA WELLNESSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Mr. Charles Eldridge
Title
President and Ceo
Phone
(714) 745-6191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

2308B W Highway 66
Stroud, OK 74079-6729

Mailing address

2308B W Highway 66
Stroud, OK 74079-6729
Phone (714) 745-6191

Other identifiers 2

IdentifierTypeStateIssuer
54-3181OtherOKMEDICARE
200651120AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cameron.ethridge@occs.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161205002327 OK Part B Supplier - Clinic/Group Practice 9032499231 Receives reassigned benefits from 8 practitioners
Practice locations: Stroud, OK

National Provider Directory

National Provider Directory

Locations

2308B W Highway 66
Stroud, OK 74079
Phone (918) 968-1642

Practitioners & affiliated clinicians

Practitioners 8

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": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1073969358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308B W HIGHWAY 66",
            "city": "STROUD",
            "state": "OK",
            "postal_code": "740796729",
            "telephone_number": "714-745-6191",
            "fax_number": "918-968-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308B W HIGHWAY 66",
            "city": "STROUD",
            "state": "OK",
            "postal_code": "740796729",
            "telephone_number": "714-745-6191",
            "fax_number": "918-968-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE CURA FAMILY CLINIC-STROUD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONE CURA WELLNESS",
        "enumeration_date": "2016-05-05",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "714-745-6191",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "54-3181",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200651120A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cameron.ethridge@occs.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2308B W Highway 66",
            "city": "Stroud",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740796729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stroud, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.

Verify at the official NPI Registry.