NPIMap

Organization Active NPI

Bristow Endeavor Healthcare, LLC

Doing business as Bristow Family Practice, Urgent Care

  • Family Medicine Physician
  • Bristow, OK
National Provider Identifier
1265863583
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BRISTOW ENDEAVOR HEALTHCARE, LLC
Doing business as
Bristow Family Practice, Urgent Care
CORE Outreach Specialists
Practice address
519 N Main St
Bristow, OK 74010-2016
Phone
(918) 367-6611
Fax
(918) 367-9915
NPI assigned
Dec 12, 2013
Last updated
Nov 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
Melinda Kay Whitaker
Title
Credentialing Coordinator
Phone
(918) 701-2313

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Otolaryngology Physician 207Y00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

519 N Main St
Bristow, OK 74010-2016

Mailing address

1809 E 13TH St Ste 300
Tulsa, OK 74104-4431
Phone (918) 701-2313

Other names 2

  • Bristow Family Practice, Urgent Care Doing business as
  • CORE Outreach Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

519 N Main St
Bristow, OK 74010
Phone (918) 367-1444

3029 W Main St
Jenks, OK 74037
Phone (918) 346-5002

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1265863583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 E 13TH ST STE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044431",
            "telephone_number": "918-701-2313",
            "fax_number": "539-235-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N MAIN ST",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102016",
            "telephone_number": "918-367-6611",
            "fax_number": "918-367-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOW ENDEAVOR HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "918-701-2313"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristow Family Practice, Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORE Outreach Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.