Children'S Clinic of Muskogee, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S CLINIC OF MUSKOGEE, LLC

Practice address

3101 Chandler Rd Ste 101
Muskogee, OK 74403-4955

Phone

(918) 687-4411

Fax

(918) 687-4448

NPI assigned

Oct 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jerry David Whatley, MD

Title

Owner

Phone

(918) 687-4411

Specialties & licenses 1

Addresses

Other names 1

• Children's Clinic of Muskogee, LLC Doing business as

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1124809918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 CHANDLER RD STE 101",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034955",
            "telephone_number": "918-687-4411",
            "fax_number": "918-687-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 CHANDLER RD STE 101",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034955",
            "telephone_number": "918-687-4411",
            "fax_number": "918-687-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC OF MUSKOGEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "WHATLEY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-687-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Clinic of Muskogee, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cherokee Nation
• Cherokee Nation
• Quintevin Raymond Cherry
• Sherika Miles Cherry
• Carissa Chesser, MSN, FNP-C
• Children'S Clinic, PLLC
• Children'S Clinic, PLLC
• Childrens Clinic LLC
• Kristopher Chinnery, PT
• Colby Renee Christian

• All providers in Muskogee, OK
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.