NPIMap

Organization Active NPI

Pro Care Family Health of Leflore County

  • Primary Care Clinic/Center
  • Poteau, OK
National Provider Identifier
1326701038
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRO CARE FAMILY HEALTH OF LEFLORE COUNTY
Practice address
1103 Dewey Ave
Poteau, OK 74953-4411
Phone
(918) 647-0670
Fax
(918) 647-0460
NPI assigned
Oct 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Evelyn Marie Tustin
Title
Manager
Phone
(918) 647-0670

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1103 Dewey Ave
Poteau, OK 74953-4411

Mailing address

PO Box 1278
Poteau, OK 74953-1278
Phone (918) 647-0670

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1326701038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1278",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749531278",
            "telephone_number": "918-647-0670",
            "fax_number": "918-647-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 DEWEY AVE",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534411",
            "telephone_number": "918-647-0670",
            "fax_number": "918-647-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO CARE FAMILY HEALTH OF LEFLORE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "TUSTIN",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-647-0670"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.