NPIMap

Organization Active NPI

Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
National Provider Identifier
1235863879
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VARIETY CARE, INC.
Practice address
11220 N Rockwell Ave
Oklahoma City, OK 73162-2725
Phone
(405) 632-6688
NPI assigned
Jul 11, 2022
Last updated
Jul 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
VARIETY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Ashley Horn
Title
Comptroller
Phone
(405) 632-6688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

11220 N Rockwell Ave
Oklahoma City, OK 73162-2725

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040105000467 OK Part B Supplier - Clinic/Group Practice 1557260007 Receives reassigned benefits from 135 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, OK; Anadarko, OK; Yukon, OK; Oklahoma City, OK; Del City, OK; Edmond, OK; Fort Cobb, OK; Grandfield, OK…
O20221006003484 OK Part A Provider - Federally Qualified Health Center (FQHC) 1557260007 Practice locations: Oklahoma City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235863879. Details of each certification follow.

Federally qualified health center certification: CCN 371981

Legal name
VARIETY CARE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 6, 2022
Last certification
Sep 6, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 17, 1980 in OK
Enrollment address
11220 N Rockwell Ave
Oklahoma City, OK 73162-2725

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 26

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

View all 26

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
37D2260013Variety Care Putnam11220 N Rockwell Ave, Oklahoma City, OK 73162Provider-performed microscopyMay 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Variety Care Inc27 organizations share this tax ID, including this one
Part of
Variety Care Inc

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

317 E Himes St
Norman, OK 73069
Phone (405) 329-4161

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mariano Acuna Individual Corporate Officer Aug 1, 2017
Rachel Ramirez Individual Corporate DirectorBoard Member Jul 1, 2019
Louise R Carmichael Individual Operational/Managerial ControlCeo Dec 1, 2004
Ashley Horn Individual Operational/Managerial ControlComptroller Nov 1, 2019
Mary Ann Martin Individual Corporate OfficerSecretary Aug 1, 2017
Leslie Warrior Individual Corporate OfficerBoard Member Aug 1, 2017
Jared Deck Individual Corporate OfficerTreasurer Aug 1, 2017
Timothy Reddout Individual Operational/Managerial ControlVP & Cfo Nov 1, 2019
Donald Nevard Individual Corporate OfficerBoard Member Aug 1, 2017
Amy Dunn Individual Corporate OfficerPresident Aug 1, 2017

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1235863879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 N ROCKWELL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731622725",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARIETY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VARIETY CARE, INC.",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "405-632-6688"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.