NPIMap

Organization Active NPI

Oklahoma Integrated Care PLC

  • Multi-Specialty Clinic/Center
  • Ardmore, OK
National Provider Identifier
1316540495
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
OKLAHOMA INTEGRATED CARE PLC
Practice address
1013 15TH Ave NW
Ardmore, OK 73401-1810
Phone
(580) 504-1517
NPI assigned
Nov 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Tasha Preston, APRNNPI 1811205925
Title
Nurse Practitioner
Phone
(580) 504-1517

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Addiction (Substance Use Disorder) Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WA0400X
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1013 15TH Ave NW
Ardmore, OK 73401-1810

Mailing address

1013 15TH Ave NW
Ardmore, OK 73401-1810
Phone (580) 238-4277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211101001490 OK Part B Supplier - Clinic/Group Practice 5193113751 Receives reassigned benefits from 11 practitioners
Practice locations: Ardmore, OK; Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1013 15th Ave NW
Ardmore, OK 73401
Phone (580) 226-4544

101 W Main St
Ste 102
Ardmore, OK 73401

117 B St SW
Ardmore, OK 73401
Phone (580) 226-3750

1720 N Shartel Ave
Ste B
Oklahoma City, OK 73103
Phone (405) 449-2323

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1316540495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 15TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011810",
            "telephone_number": "580-238-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 15TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011810",
            "telephone_number": "580-504-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA INTEGRATED CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "580-504-1517",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.