Organization Active NPI

Gideon Family Care LLC

  • Primary Care Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1487227617
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GIDEON FAMILY CARE LLC
Practice address
1601 SW 89TH St Ste D200
Oklahoma City, OK 73159-6383
Phone
(405) 698-0156
NPI assigned
Jul 24, 2021
Last updated
Sep 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Authorized official

Name
Amber Crosby, NPNPI 1740556562
Title
Nurse Practitioner
Phone
(405) 708-4498

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

1601 SW 89TH St Ste D200
Oklahoma City, OK 73159-6383

Mailing address

1601 SW 89TH St Ste D200
Oklahoma City, OK 73159-6383
Phone (405) 708-4498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210921000317 OK Part B Supplier - Clinic/Group Practice 9032516976 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, 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
37D2235200Gideon Family Care1601 SW 89TH St, Ste D200, Oklahoma City, OK 73159Certificate of waiverSep 6, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1627084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1487227617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE D200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596383",
            "telephone_number": "405-708-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE D200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596383",
            "telephone_number": "405-698-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIDEON FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-24",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "405-708-4498",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; 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.