NPIMap

Organization Active NPI

Immediate Care of Oklahoma LLC

  • Urgent Care Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1164697694
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
IMMEDIATE CARE OF OKLAHOMA LLC
Practice address
11808 South May Avenue
Oklahoma City, OK 73170-2560
Phone
(405) 735-2370
Fax
(405) 735-2369
NPI assigned
Apr 25, 2008
Last updated
Apr 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Kevin Penwell, DONPI 1841286333
Title
Com
Phone
(405) 378-2197

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 1

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

Addresses

Primary practice location

11808 South May Avenue
Oklahoma City, OK 73170-2560

Mailing address

PO Box 721776
Norman, OK 73070-8360
Phone (405) 600-6869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081002000355 OK Part B Supplier - Clinic/Group Practice 2668540774 Receives reassigned benefits from 50 practitioners
3 other NPIs on this enrollment
Practice locations: Choctaw, OK; Edmond, OK; Norman, OK; Oklahoma City, OK; Tecumseh, OK; Yukon, OK

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1086372Immediate Care of Oklahoma S May11808 S May Ave, Oklahoma City, OK 73170Certificate of waiverJun 2, 2028

National Provider Directory

National Provider Directory

Locations

1664 S Choctaw Rd
Choctaw, OK 73020
Phone (405) 281-2144

5700 SE 74th St
Oklahoma City, OK 73135
Phone (405) 809-8713

10616 W Highway 66
#100
Yukon, OK 73099

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1164697694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721776",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730708360",
            "telephone_number": "405-600-6869",
            "fax_number": "405-600-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 SOUTH MAY AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731702560",
            "telephone_number": "405-735-2370",
            "fax_number": "405-735-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE CARE OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "PENWELL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "COM",
        "authorized_official_telephone_number": "405-378-2197",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.