Cornerstone Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CORNERSTONE FAMILY MEDICINE PLLC

Practice address

4902 Oklahoma Ave
Woodward, OK 73801-3713

Phone

(580) 254-5316

Fax

(580) 254-0130

NPI assigned

Jan 10, 2023

Organization subpart

No

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

Authorized official

Name

Keenan Ferguson, DONPI 1154309466

Title

Owner/Physician

Phone

(580) 254-5316

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

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.

• Keenan L Ferguson, D.O.

  • Family Medicine Physician
  • Cherokee, OK
  • NPI 1154309466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1376257832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 DOWNS AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738015328",
            "telephone_number": "580-254-5316",
            "fax_number": "580-254-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 OKLAHOMA AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013713",
            "telephone_number": "580-254-5316",
            "fax_number": "580-254-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "580-254-5316",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Cole, C-CHW
• Garrett Lee Collier, PHARMD
• Gregory S Cook, OD INC.
• Ashley Dawn Corder
• Core Values LLC (Hearing Group)
• Madeline Kaye Cortez, APRN FNP-C
• Courtney Coshow
• Debbie Dawn Covalt
• Genevie Cox
• Amanda Cupp

• Family Medicine Physician in Woodward, OK
• Providers in Woodward, 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 Jan 10, 2023; 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.