Organization Active NPI

Restore Family Medical Clinic

  • Family Nurse Practitioner
  • Antlers, OK
National Provider Identifier
1528545472
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
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

Updated by the provider on Dec 12, 2025

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

Authorized official

Name
Terry Jean Draper, APRN-CNPNPI 1942793351
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)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 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
37D2151033Restore Family Medical Clinic416020 E 1951 Rd, Antlers, OK 74523Certificate of waiverJul 9, 2028

National Provider Directory

National Provider Directory

Practitioners & 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.

Verify at the official NPI Registry.