Procare Healing Centers, LLC

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

PROCARE HEALING CENTERS, LLC

Practice address

3501 W Broadway St
Muskogee, OK 74401-2138

Phone

(866) 306-4461

Fax

(405) 300-1336

NPI assigned

Jun 6, 2024

Organization subpart

No

Name

Trenton Stillwell

Title

President

Phone

(866) 306-4461

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Johnson, APRN

  • Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1912546144
  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2025.

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1437991908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012138",
            "telephone_number": "866-306-4461",
            "fax_number": "405-300-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012138",
            "telephone_number": "866-306-4461",
            "fax_number": "405-300-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE HEALING CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "STILLWELL",
        "authorized_official_first_name": "TRENTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-306-4461"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Muskogee, OK
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.