NPIMap

Organization Active NPI

Central Oklahoma Family Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ada, OK
National Provider Identifier
1144997693
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC
Practice address
2901 Arlington St
Ada, OK 74820-2928
Phone
(580) 436-5111
Fax
(580) 436-1159
NPI assigned
Aug 24, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Brenda Ware
Title
Ceo
Phone
(580) 925-3286

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Federally qualified health center certification: CCN 371969

Legal name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 20, 2021
Last certification
Oct 20, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 2001 in OK
Enrollment address
2901 Arlington St
Ada, OK 74820-2928

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040722001013 OK Part B Supplier - Clinic/Group Practice 9931189685 Receives reassigned benefits from 68 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seminole, OK; Stratford,, OK; Konawa, OK; Ada, OK
O20211022000499 OK Part A Provider - Federally Qualified Health Center (FQHC) 9931189685 Practice locations: Ada, OK

All disclosed owners & managing parties 8

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carla Presley Individual Other Sep 25, 2017
Meagan Brooking Individual Other Aug 24, 2017
Brenda Ware Individual Operational/Managerial Control Mar 25, 2002
Ramona Bunch Individual Other Jan 25, 2016
Susan Coleman Individual Other Jan 25, 2016
Bruce a Bennett Individual Other Aug 24, 2017
Yvette McDonald Individual Other Nov 23, 2015
Central Oklahoma Family Medical Center Inc Organization, Konawa, OK Non-profit Operational/Managerial Control Sep 1, 2021

All facility ownership & control disclosures 9

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Central Oklahoma Family Medical Center IncAda, OK, CCN 371936 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 1986
Central Oklahoma Family Medical Center IncStratford, OK, CCN 371948 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 2019
Central Oklahoma Family Medical Center IncAda, OK, CCN 371965 Federally qualified health center Operational/Managerial Control (100%) Mar 25, 2002
Central Oklahoma Family Medical Center IncAda, OK, CCN 371972 Federally qualified health center Operational/Managerial Control Sep 1, 2021
Central Oklahoma Family Medical Center IncAda, OK, CCN 371976 Federally qualified health center Operational/Managerial Control Jan 11, 2022
Central Oklahoma Family Medical Center IncSeminole, OK, CCN 371977 Federally qualified health center Operational/Managerial Control May 3, 2022
Central Oklahoma Family Medical Center IncAda, OK, CCN 371978 Federally qualified health center Operational/Managerial Control Jun 1, 2022
Central Oklahoma Family Medical Center IncAda, OK, CCN 371979 Federally qualified health center Operational/Managerial Control Feb 1, 2022
Central Oklahoma Family Medical Center IncSeminole, OK, CCN 371005 Federally qualified health center Operational/Managerial Control (100%) Mar 25, 2002

National Provider Directory

National Provider Directory
Tax ID family
Central Ok Family Med Ctr31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

2901 Arlington St
Ada, OK 74820-2928

Mailing address

527 W 3Rd St
Konawa, OK 74849-1415
Phone (580) 925-3286

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 24, 2021.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1144997693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 ARLINGTON ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202928",
            "telephone_number": "580-436-5111",
            "fax_number": "580-436-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-925-3286"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.