NPIMap

Organization Active NPI

Variety Care, Inc.

Doing business as Variety Care Turtle Creek

  • Federally Qualified Health Center (FQHC)
  • Edmond, OK
National Provider Identifier
1477347789
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VARIETY CARE, INC.
Doing business as
Variety Care Turtle Creek
Practice address
2000 E 15TH St Ste 400a
Edmond, OK 73013-6673
Phone
(405) 632-6688
NPI assigned
Apr 9, 2025
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
VARIETY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Nadine M Davidson
Title
Dir. of Revenue Cycle Management
Phone
(405) 632-6688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2000 E 15TH St Ste 400a
Edmond, OK 73013-6673

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other names 1

  • Variety Care Turtle Creek Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040105000467 OK Part B Supplier - Clinic/Group Practice 1557260007 Receives reassigned benefits from 135 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, OK; Anadarko, OK; Yukon, OK; Oklahoma City, OK; Del City, OK; Edmond, OK; Fort Cobb, OK; Grandfield, OK…
O20250818001736 OK Part A Provider - Federally Qualified Health Center (FQHC) 1557260007 Practice locations: Edmond, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477347789. Details of each certification follow.

Federally qualified health center certification: CCN 371055

Legal name
VARIETY CARE, INC.
Doing business as
VARIETY CARE TURTLE CREEK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 18, 2025
Last certification
Jul 18, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2000 E 15TH St
Ste 400a
Edmond, OK 73013-6673

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Variety Care Inc27 organizations share this tax ID, including this one
Part of
Variety Care Inc

Other organizations with this tax ID 26

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

View all 26

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Louise R Carmichael Individual Operational/Managerial ControlCeo & Board President Dec 1, 2004
Ana Deisy Escalera Individual Corporate OfficerBoard Vice Chair Dec 1, 2020
Leslie Warrior Individual Corporate OfficerBoard Secretary Mar 1, 2017
Jason Pledger Individual Corporate OfficerBoard Chair Jul 1, 2018
Timothy Reddout Individual Operational/Managerial ControlVice President of Administration Nov 1, 2019
Nadine Davidson Individual Operational/Managerial ControlDirector of Revenue Cycle MGMT Sep 3, 2019
Donald Nevard Individual Corporate OfficerBoard Treasurer Jun 1, 2022

Practitioners & affiliated clinicians

Practitioners 4

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": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1477347789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E 15TH ST STE 400A",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136673",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARIETY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VARIETY CARE, INC.",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "NADINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIR. OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "405-632-6688"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Variety Care Turtle Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.