Broken Arrow Family Practice Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BROKEN ARROW FAMILY PRACTICE CENTER

Practice address

817 S Elm PL Ste a
Broken Arrow, OK 74012-5369

Phone

(918) 251-2273

Fax

(918) 258-6446

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Douglas Holte, M.D.NPI 1558332676

Title

Owner

Phone

(918) 251-2273

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Douglas W Holte, MD

  • Family Medicine Physician
  • Broken Arrow, OK
  • NPI 1558332676

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1659405488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S ELM PL STE A",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125369",
            "telephone_number": "918-251-2273",
            "fax_number": "918-258-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S ELM PL STE A",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125369",
            "telephone_number": "918-251-2273",
            "fax_number": "918-258-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW FAMILY PRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "HOLTE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-251-2273",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100172440D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00389602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broken Arrow Dental and Implants, LLC
• Broken Arrow Diagnostic Medicine, PLLC
• Broken Arrow Endodontics
• Broken Arrow Family Clinic Inc
• Broken Arrow Family Dentistry PLLC
• Broken Arrow Family Practice Center PLC
• Broken Arrow Medical Center Inc
• Broken Arrow Medical Center Inc
• Broken Arrow Medical Center, Inc
• Broken Arrow Nursing Home Inc

• All providers in Broken Arrow, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.