NPIMap

Organization Active NPI

Destiny Urgent and Primary Care Clinic. LLC

  • Nurse Practitioner
  • Catoosa, OK
National Provider Identifier
1437738804
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DESTINY URGENT AND PRIMARY CARE CLINIC. LLC
Practice address
1818 N Highway 66 Ste B
Catoosa, OK 74015-3052
Phone
(417) 317-3388
NPI assigned
Apr 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Ernest Kaara Maina, FNP
Title
Owner/Provider
Phone
(417) 317-3388

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1818 N Highway 66 Ste B
Catoosa, OK 74015-3052

Mailing address

1000 W Elmira St
Broken Arrow, OK 74012-0872
Phone (417) 317-3388

Other identifiers 1

IdentifierTypeStateIssuer
1740751445OtherOKNPI#

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1437738804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W ELMIRA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120872",
            "telephone_number": "417-317-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N HIGHWAY 66 STE B",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740153052",
            "telephone_number": "417-317-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY URGENT AND PRIMARY CARE CLINIC. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "MAINA",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "KAARA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "417-317-3388",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI#",
            "identifier": "1740751445",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catoosa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.