Thackerville Medical Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0096598 Issued in OK

Legal business name

THACKERVILLE MEDICAL CLINIC

Practice address

11530 Ridge Rd Ste 1
Thackerville, OK 73459-9771

Phone

(580) 276-9066

Fax

(580) 276-9063

NPI assigned

Apr 7, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Dana Carol Sprott, ARNP

Title

Nurse Practitioner/Owner

Phone

(940) 366-0180

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1518282185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 RIDGE RD STE 1",
            "city": "THACKERVILLE",
            "state": "OK",
            "postal_code": "734599771",
            "telephone_number": "580-276-9066",
            "fax_number": "580-276-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 RIDGE RD STE 1",
            "city": "THACKERVILLE",
            "state": "OK",
            "postal_code": "734599771",
            "telephone_number": "580-276-9066",
            "fax_number": "580-276-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THACKERVILLE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "SPROTT",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "940-366-0180",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0096598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rainey Jo Hitt, RN
• Casey Jon Hucks, LPC
• Cynthia Pickens
• Red River Valley Health PLLC
• Thackerville Pharmacy
• Thackerville Public Schools

• Family Nurse Practitioner in Thackerville, OK
• Providers in Thackerville, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.