NPIMap

Organization Active NPI

Integris Ambulatory Care Corporation

  • Rehabilitation Clinic/Center
  • Grove, OK
National Provider Identifier
1477090652
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
INTEGRIS AMBULATORY CARE CORPORATION
Practice address
2203 S Main St
Grove, OK 74344-5329
Phone
(918) 786-3797
NPI assigned
Jan 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Michael L Weed
Title
Treasurer
Phone
(405) 951-2737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

2203 S Main St
Grove, OK 74344-5329

Mailing address

PO Box 843754
Kansas City, MO 64184-3754
Phone (405) 252-8400

Other identifiers 1

IdentifierTypeStateIssuer
100736700AMedicaidOK

Other names 1

  • INTEGRIS Health Jim Thorpe Outpatient Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070830000788 OK Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4284546490 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oklahoma City, OK; Enid, OK; Grove, OK; Edmond, OK; Bethany, OK; Moore, OK

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Integris Int Med Central10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

2203 S Main St
Grove, OK 74344
Phone (918) 786-3795

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1477090652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843754",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843754",
            "telephone_number": "405-252-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743445329",
            "telephone_number": "918-786-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS AMBULATORY CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "WEED",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "405-951-2737"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100736700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Health Jim Thorpe Outpatient Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.