Bristow Endeavor Healthcare, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRISTOW ENDEAVOR HEALTHCARE, LLC

Doing business as

Prague Healthcare Center

Practice address

810 9TH St
Prague, OK 74864-4582

Phone

(405) 566-3411

Fax

(405) 566-3410

NPI assigned

Mar 20, 2019

Last updated

May 30, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

BRISTOW ENDEAVOR HEALTHCARE, LLCAs reported in NPPES

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 1

Addresses

Other names 1

• Prague Healthcare Center Doing business as

Part of

Bristow Endeavor Healthcare LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Bristow Endeavor Healthcare, LLC

  dba Bristow Family Practice, Urgent Care

  • Family Medicine Physician
  • Bristow, OK
  • NPI 1265863583
  NPPES parent name

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1275093098",
    "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": "810 9TH ST",
            "city": "PRAGUE",
            "state": "OK",
            "postal_code": "748644582",
            "telephone_number": "405-566-3411",
            "fax_number": "405-566-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOW ENDEAVOR HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTOW ENDEAVOR HEALTHCARE, LLC",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prague Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prague Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Acadiana Healthcare of Oklahoma, Inc. (Prague Municipal Hospital)
• Adjust Chiropractic PLLC
• Allcare Pharmacy Flowers & Gifts Inc
• Heather Faye Annis, M.S., LPC
• Raven Wind Ayers
• Chasitee Qwinette Burdine
• Abigail Jean Burris
• Care Nursing Home Inc. (Parkland Manor)
• Charles Albert Cashman, DDS
• Central Ok Family Med Ctr

• Family Medicine Physician in Prague, OK
• Providers in Prague, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.