Eastpointe Medical Clinic Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

EASTPOINTE MEDICAL CLINIC INC

Practice address

1506 S Broadway St
Poteau, OK 74953-2900

Phone

(903) 495-1105

NPI assigned

Oct 27, 2015

Last updated

Feb 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Roxann ShawNPI 1265660252

Title

President

Phone

(903) 495-1105

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Roxann Latoya Shaw, CRNA

  • Certified Registered Nurse Anesthetist
  • Lawrenceville, GA
  • NPI 1265660252
  NPD (past) Authorized official

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1558733782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 S BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532900",
            "telephone_number": "918-647-7046",
            "fax_number": "918-647-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532900",
            "telephone_number": "903-495-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTPOINTE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-27",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ROXANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-495-1105",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200633990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Jean Duplissey
• Bonnie Dyer
• Eastern Oklahoma Healthcare Corp
• Eastern Oklahoma Medical Center
• Eastern Oklahoma Mental Health & Counseling LLC (Eomhc)
• Cora L. Eckenberger, L.P.C.
• Corinne Yvonne Elkins
• Tracy Kent Ellis
• Erika Elmore
• Sierra Elmore

• Community Health Clinic/Center in Poteau, OK
• Providers in Poteau, OK by specialty
• Community Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.