Crestcare Family Medicine,PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CRESTCARE FAMILY MEDICINE,PLLC

Practice address

817 S Elm PL Ste 104
Broken Arrow, OK 74012-5369

Phone

(918) 251-9698

Fax

(405) 241-9022

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Gaurangi M Anklesaria, MDNPI 1659457703

Title

Owner

Phone

(918) 251-9698

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gaurangi Manek Anklesaria, M.D.

  • Family Medicine Physician
  • Broken Arrow, OK
  • NPI 1659457703

  Family Medicine

  NPD Authorized official

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1174139554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S ELM PL STE 104",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125369",
            "telephone_number": "918-251-9698",
            "fax_number": "405-241-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S ELM PL STE 104",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125369",
            "telephone_number": "918-251-9698",
            "fax_number": "405-241-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTCARE FAMILY MEDICINE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "ANKLESARIA",
        "authorized_official_first_name": "GAURANGI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-251-9698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Broken Arrow, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.