Organization Active NPI

AMC Urgent Care Plus, LLC

  • General Practice Physician
  • Ponca City, OK
National Provider Identifier
1285644153
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AMC URGENT CARE PLUS, LLC
Practice address
2101 N 14TH St
Ste 114
Ponca City, OK 74601-1807
Phone
(580) 762-1552
NPI assigned
Aug 9, 2006
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Keri Self
Title
Operations Manager
Phone
(580) 762-2366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

2101 N 14TH St
Ste 114
Ponca City, OK 74601-1807

Mailing address

2101 N 14TH St
Ste 114
Ponca City, OK 74601-1807
Phone (580) 762-1552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061007000015 OK Part B Supplier - Clinic/Group Practice 3971509381 Receives reassigned benefits from 31 practitioners
Practice locations: Broken Arrow, OK; Owasso, OK; Ponca City, OK; Stillwater, OK

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
37D1062738AMC Urgent Care Plus2101 N 14TH Street Ste 114, Ponca City, OK 74601AccreditationJun 23, 2028

National Provider Directory

National Provider Directory

Locations

816 W Tucson St
Broken Arrow, OK 74011
Phone (580) 762-2366

9003 N Garnett Rd
Owasso, OK 74055
Phone (918) 272-2882

2101 N 14th St
Ste 114
Ponca City, OK 74601
Phone (580) 762-1552

1909 W 6th Ave
#B
Stillwater, OK 74074
Phone (405) 385-0029

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1285644153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N 14TH ST",
            "address_2": "STE 114",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011807",
            "telephone_number": "580-762-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N 14TH ST",
            "address_2": "STE 114",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011807",
            "telephone_number": "580-762-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMC URGENT CARE PLUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "580-762-2366"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.