NPIMap

Organization Active NPI

Central Oklahoma Family Medical Center

  • Registered Nurse
  • Konawa, OK
National Provider Identifier
1407015530
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER
Practice address
527 W 3Rd St
Konawa, OK 74849-1415
Phone
(580) 925-3286
Fax
(580) 925-2362
NPI assigned
Jun 4, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Casey Harold Anson
Title
Executive Director
Phone
(580) 925-3286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X Primary

Addresses

Primary practice location

527 W 3Rd St
Konawa, OK 74849-1415

Mailing address

527 W 3Rd St
Konawa, OK 74849-1415
Phone (580) 925-3286

Other identifiers 1

IdentifierTypeStateIssuer
100737160PMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Cletas Cottage Day Treatment Center31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1407015530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OKLAHOMA FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "ANSON",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-925-3286"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100737160P",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Konawa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.