NPIMap

Organization Active NPI

Urgent Care of Pauls Valley Aprn-CNP LLC

  • Urgent Care Clinic/Center
  • Pauls Valley, OK
National Provider Identifier
1477097699
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
URGENT CARE OF PAULS VALLEY APRN-CNP LLC
Practice address
2000 W Grant Ave
Suite 2
Pauls Valley, OK 73075-9233
Phone
(405) 238-3900
Fax
(405) 238-3903
NPI assigned
Dec 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Authorized official

Name
Ms. Letitia L Jackson, APRN-CNPNPI 1063812634
Title
Nurse Practitioner / Owner
Phone
(405) 238-3900

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2000 W Grant Ave
Suite 2
Pauls Valley, OK 73075-9233

Mailing address

2000 W Grant Ave
Suite 2
Pauls Valley, OK 73075-9233
Phone (405) 238-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170128000077 OK Part B Supplier - Clinic/Group Practice 7719269646 Receives reassigned benefits from 1 practitioner
Practice locations: Pauls Valley, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1477097699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W GRANT AVE",
            "address_2": "SUITE 2",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730759233",
            "telephone_number": "405-238-3900",
            "fax_number": "405-238-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W GRANT AVE",
            "address_2": "SUITE 2",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730759233",
            "telephone_number": "405-238-3900",
            "fax_number": "405-238-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE OF PAULS VALLEY APRN-CNP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LETITIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER / OWNER",
        "authorized_official_telephone_number": "405-238-3900",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pauls Valley, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.