Washita Medical Center LLC
Organization Active NPI Primary Care Clinic/Center · Davis, OK
NPI 1356925473 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1356925473
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- WASHITA MEDICAL CENTER LLC
- Practice address
- 38509 State Hwy 7
Davis, OK 73030 - Phone
- (405) 207-7696
- Fax
- (800) 396-6706
- NPI assigned
- May 6, 2021
- Organization subpart
- No
Authorized official
- Name
- Stefanie Fisher, APN
- Title
- Apn/Provider
- Phone
- (405) 207-7696
Practitioners 4
-
Stefanie Jane McKee, NP-C
-
Angela Michele Heath, PA-C
-
Ashli Elizabeth Stamper, APRN, CNP
-
Micki Richardson, APRN-CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210714000241 | OK | Part B Supplier - Clinic/Group Practice | 3274932884 |
Receives reassigned benefits from 1 practitioner Practice locations: Davis, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
38509 State Hwy 7
Davis, OK 73030
Mailing address
PO Box 157
Hennepin, OK 73444-0157
Phone (405) 207-7696
Other providers in Davis, OK
- Kimberly J. Tabor
- Phillip Carl Tabor Jr.
- Janie Marie Taylor
- Tonya James
- Traditions Health Care of Purcell, LLC
- Alisha N White
- Heidi Brooke Wright
All providers in Davis, OK · Primary Care Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.