Hussains Family Practice RHC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

89829 Issued in OK

Legal business name

HUSSAINS FAMILY PRACTICE RHC

Doing business as

Hussains Family Practice

Practice address

139 E Main St
Wilburton, OK 74578-4229

Phone

(918) 465-5727

Fax

(918) 465-3311

NPI assigned

Mar 20, 2007

Last updated

May 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ahmer Hussain, MDNPI 1124093414

Title

Owner

Phone

(918) 465-5727

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Hussains Family Practice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407971492. Details of each certification follow.

• CCN 373876 Rural health clinic · Active · Name & address match · Details

Rural health clinic certification: CCN 373876

Legal name

HUSSAINS FAMILY PRACTICE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 5, 2005

Last certification

Aug 21, 2014

Ownership / control type

1A

Facility address

139 East Main Street
Wilburton, OK 74578

Practitioners 2

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.

• Ahmer Hussain

  • Emergency Medicine Physician
  • Poteau, OK
  • NPI 1124093414
  NPD (past) Authorized official
• Robert Eugene Vandiver II, P.A.

  • Physician Assistant
  • Wilburton, OK
  • NPI 1417090770
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1407971492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 E MAIN ST",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745784229",
            "telephone_number": "918-465-5727",
            "fax_number": "918-465-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E MAIN ST",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745784229",
            "telephone_number": "918-465-5727",
            "fax_number": "918-465-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSSAINS FAMILY PRACTICE RHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "HUSSAIN",
        "authorized_official_first_name": "AHMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-465-5727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "89829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHMER HUSSAIN M.D. NPI",
            "identifier": "1124093414",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "SB1453",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407971492",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hussains Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Ann Holman, FNP-BC
• Home Care Medical Supplies Inc
• Jennifer Houston
• Janet Elaine Hugle
• Tiffany Hunnicutt, LCSW
• Idwi, Inc
• Richard Edward Ingram, D.C.
• Stephenie Renee Ingram, CNP-FAMILY
• Melonie Jackson
• Debra Ann Jacobs

• Adult Health Nurse Practitioner in Wilburton, OK
• Providers in Wilburton, OK by specialty
• Adult Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.