NPIMap

Organization Active NPI

Pathways Medical LLC

  • Primary Care Clinic/Center
  • Edmond, OK
National Provider Identifier
1194185090
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PATHWAYS MEDICAL LLC
Practice address
13707 Fairhill Ave
Edmond, OK 73013
Phone
(405) 607-4041
Fax
(405) 463-0090
NPI assigned
Mar 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Authorized official

Name
Zachory Randall, LPC, LADCNPI 1386960912
Title
Ceo/President
Phone
(405) 607-4041

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

13707 Fairhill Ave
Edmond, OK 73013

Mailing address

13707 Fairhill Ave
Edmond, OK 73013
Phone (405) 607-4041

Other identifiers 1

IdentifierTypeStateIssuer
200640210AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160915001575 OK Part B Supplier - Clinic/Group Practice 6901192046 Receives reassigned benefits from 4 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

13707 Fairhill Ave
Edmond, OK 73013
Phone (405) 412-3494

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13010/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 74

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

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780704000000",
    "number": "1194185090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "ZACHORY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "405-607-4041",
        "authorized_official_credential": "LPC, LADC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200640210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.