Active NPI
Restore Family Medical Clinic
- Family Nurse Practitioner
- Antlers, OK
National Provider Identifier
1528545472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- RESTORE FAMILY MEDICAL CLINIC
- Practice address
- 416020 E 1951 Rd
Antlers, OK 74523 - Phone
- (580) 982-6044
- NPI assigned
- Jul 24, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Jean Draper, APRN-CNP
- Title
- President
- Phone
- (580) 982-6044
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
416020 E 1951 Rd
Antlers, OK 74523
Mailing address
416020 E 1951 Rd
Antlers, OK 74523-7445
Phone (580) 982-6044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180828000306 | OK | Part B Supplier - Clinic/Group Practice | 8921357765 |
Receives reassigned benefits from 1 practitioner Practice locations: Antlers, OK |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2151033 | Restore Family Medical Clinic | Certificate of waiver | Jul 9, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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": "1532390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1765497600000",
"number": "1528545472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416020 E 1951 RD",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745237445",
"telephone_number": "580-982-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416020 E 1951 RD",
"city": "ANTLERS",
"state": "OK",
"postal_code": "74523",
"telephone_number": "580-982-6044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RESTORE FAMILY MEDICAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-24",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A",
"authorized_official_last_name": "DRAPER",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "JEAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "580-982-6044",
"authorized_official_credential": "APRN-CNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Antlers, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; 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.