NPIMap

Organization Active NPI

Northeast Oklahoma Physician Network Inc

Doing business as Broken Arrow Urgent Care

  • Urgent Care Clinic/Center
  • Broken Arrow, OK
National Provider Identifier
1205190501
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
NORTHEAST OKLAHOMA PHYSICIAN NETWORK INC
Doing business as
Broken Arrow Urgent Care
Practice address
1130 E Lansing St
Broken Arrow, OK 74012-2429
Phone
(918) 258-9990
Fax
(918) 994-4277
NPI assigned
Jul 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Richard Ferguson
Title
Ceo
Phone
(918) 477-5049

Specialties & licenses 1

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

Addresses

Primary practice location

1130 E Lansing St
Broken Arrow, OK 74012-2429

Mailing address

2408 E 81St St
Ste 300
Tulsa, OK 74137-4200
Phone (918) 477-5049

Other names 1

  • Broken Arrow Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000427 OK Part B Supplier - Clinic/Group Practice 8527224252 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Broken Arrow, OK; Tulsa, OK

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1130 E Lansing St
Ste A
Broken Arrow, OK 74012
Phone (918) 258-9990

1130 E Lansing St
Ste B
Broken Arrow, OK 74012
Phone (918) 258-9111

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1205190501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 E 81ST ST",
            "address_2": "STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374200",
            "telephone_number": "918-477-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9990",
            "fax_number": "918-994-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OKLAHOMA PHYSICIAN NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-477-5049"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broken Arrow Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.