Immediate Care of Oklahoma LLC

Organization Active NPI Urgent Care Clinic/Center · Oklahoma City, OK

NPI 1164697694 · NPPES record last updated Apr 3, 2014

Key facts

NPI
1164697694
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 3

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

Practitioners 52

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

View all 52

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1086372Immediate Care of Oklahoma S May
11808 S May Ave, Oklahoma City, OK 73170
Certificate of waiverJun 2, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

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

National Provider Directory

Locations

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

1664 S Choctaw Rd
Ste 101
Choctaw, OK 73020
Phone (405) 281-2144

805 W Covell Rd
Ste 200
Edmond, OK 73003
Phone (405) 216-5373

3321 W Tecumseh Rd
Ste 125
Norman, OK 73072
Phone (405) 307-6900

10616 W Highway 66
#100
Yukon, OK 73099

Specialties & licenses

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

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

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Urgent Care Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.