NPIMap

Organization Active NPI

Arkansas Verdigris Valley Health Centers,Inc.

  • Family Medicine Physician
  • Muskogee, OK
National Provider Identifier
1598022899
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC.
Practice address
110 W Martin Luther King St
Muskogee, OK 74401
Phone
(918) 483-0111
Fax
(918) 483-0112
NPI assigned
Apr 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Sonya L Smith
Title
Ceo
Phone
(918) 483-0111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

110 W Martin Luther King St
Muskogee, OK 74401

Mailing address

PO Box 334
Porter, OK 74454-0334
Phone (918) 483-0111

Other names 1

  • MUSKOGEE HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070822000520 OK Part B Supplier - Clinic/Group Practice 2961594916 Receives reassigned benefits from 12 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coweta, OK; Muskogee, OK; Porter, OK
O20130115000161 OK Part A Provider - Federally Qualified Health Center (FQHC) 2961594916 Practice locations: Muskogee, OK

Federally qualified health center certification: CCN 371881

Legal name
ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS, INC.
Doing business as
MUSKOGEE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 15, 2013
Last certification
Jan 15, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 9, 2005 in OK
Enrollment address
110 W Martin Luther King Street
Muskogee, OK 74401-3321

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
37D2046480Muskogee Health Center110 W Martin Luther King St, Muskogee, OK 74401Certificate of waiverSep 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Verdigris Valley Health Centers Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Wade Rousselot Individual Corporate Director Dec 7, 2021
Sonya Smith Individual Corporate OfficerCeo Jul 1, 2016 100%
W-2 Managing EmployeeCeo Jul 1, 2016 100%
Operational/Managerial ControlCeo Jul 1, 2016 100%
Benjamin T Harmon Individual Corporate DirectorBoard Member Nov 21, 2005
Yolanda K Harmon Individual Corporate OfficerPresident Jan 1, 2020
Chad E Marshall Individual Corporate OfficerTreasurer Dec 7, 2021
Elizabeth a Acree Individual Corporate OfficerSecretary Dec 7, 2021
Lewis a Parnell Individual Corporate Director Dec 7, 2021
Martha Diaz Deleon Individual Corporate DirectorBoard Member Jan 30, 2018
William C Waggoner Individual Corporate DirectorBoard Member Jan 22, 2009
Shirley M Herring Individual Corporate OfficerVice President Jan 1, 2020
Tyler Lang Individual Corporate Director Jul 20, 2021

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1598022899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "PORTER",
            "state": "OK",
            "postal_code": "744540334",
            "telephone_number": "918-483-0111",
            "fax_number": "918-483-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MARTIN LUTHER KING ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-483-0111",
            "fax_number": "918-483-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-483-0111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSKOGEE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUSKOGEE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.