Organization Active NPI

Southeast Oklahoma Medical Clinic, LLC

  • Primary Care Clinic/Center
  • McAlester, OK
National Provider Identifier
1467993253
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTHEAST OKLAHOMA MEDICAL CLINIC, LLC
Practice address
1308 E Carl Albert Pkwy
McAlester, OK 74501-5236
Phone
(580) 927-2334
NPI assigned
Mar 14, 2017
Last updated
Mar 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Richard J Helton, D.O.NPI 1972545820
Title
Owner
Phone
(580) 927-2334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1308 E Carl Albert Pkwy
McAlester, OK 74501-5236

Mailing address

108 W Ohio Ave
Coalgate, OK 74538-2827
Phone (580) 927-2334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171107001072 OK Part B Supplier - Clinic/Group Practice 8527324680 Receives reassigned benefits from 5 practitioners
Practice locations: McAlester, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2170368Southeast Medical Clinic, LLC1308 E Carl Albert Parkway, McAlester, OK 74501Certificate of waiverAug 8, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1467993253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W OHIO AVE",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745382827",
            "telephone_number": "580-927-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 E CARL ALBERT PKWY",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015236",
            "telephone_number": "580-927-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST OKLAHOMA MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "HELTON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-927-2334",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.