Organization Active NPI

Paragon Geriatric Associates, LLC

  • Urgent Care Clinic/Center
  • Edmond, OK
National Provider Identifier
1093382467
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PARAGON GERIATRIC ASSOCIATES, LLC
Practice address
15112 Traditions Blvd Ste a
Edmond, OK 73013-1182
Phone
(405) 289-0483
Fax
(405) 266-6609
NPI assigned
Jun 5, 2021
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Rebecca A Vernier
Title
Office Manager
Phone
(405) 289-0483

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

15112 Traditions Blvd Ste a
Edmond, OK 73013-1182

Mailing address

15112 Traditions Blvd Ste a
Edmond, OK 73013-1182
Phone (405) 289-0483

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210706000400 OK Part B Supplier - Clinic/Group Practice 9537561147 Receives reassigned benefits from 3 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

5601 NW 72nd St
Ste 245
Warr Acres, OK 73132
Phone (405) 289-0483

Practitioners & affiliated clinicians

Practitioners 4

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": "1622851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1093382467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15112 TRADITIONS BLVD STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131182",
            "telephone_number": "405-289-0483",
            "fax_number": "405-266-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15112 TRADITIONS BLVD STE A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131182",
            "telephone_number": "405-289-0483",
            "fax_number": "405-266-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON GERIATRIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-05",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "VERNIER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-289-0483"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.