NPIMap

Organization Active NPI

Variety Care, Inc.

Doing business as Variety Care Yukon

  • Federally Qualified Health Center (FQHC)
  • Yukon, OK
National Provider Identifier
1659995116
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VARIETY CARE, INC.
Doing business as
Variety Care Yukon
Practice address
1401 W Vandament Ave
Yukon, OK 73099-4666
Phone
(405) 632-6688
Fax
(844) 689-9671
NPI assigned
Jun 1, 2020
Last updated
Jun 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
VARIETY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Authorized official

Name
Nadine M Davidson
Title
Director of RCM
Phone
(405) 632-6688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1401 W Vandament Ave
Yukon, OK 73099-4666

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other names 1

  • Variety Care Yukon Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040105000467 OK Part B Supplier - Clinic/Group Practice 1557260007 Receives reassigned benefits from 135 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, OK; Anadarko, OK; Yukon, OK; Oklahoma City, OK; Del City, OK; Edmond, OK; Fort Cobb, OK; Grandfield, OK…
O20200708003128 OK Part A Provider - Federally Qualified Health Center (FQHC) 1557260007 Practice locations: Yukon, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659995116. Details of each certification follow.

Federally qualified health center certification: CCN 371957

Legal name
VARIETY CARE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 6, 2020
Last certification
Jul 6, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 17, 1980 in OK
Enrollment address
508 W Vandament Ave
Ste 210
Yukon, OK 73099-4666

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Part of
Variety Care

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632662210209

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Mariano Acuna Individual Corporate OfficerBoard Member Aug 1, 2017
Rachel Ramirez Individual Corporate DirectorBoard Member Jul 1, 2019
Louise R Carmichael Individual Operational/Managerial ControlCeo Dec 1, 2004
Mary Ann Martin Individual Corporate OfficerSecretary Aug 1, 2017
Leslie Warrior Individual Corporate OfficerBoard Member Aug 1, 2017
Jared Deck Individual Corporate OfficerTreasurer Aug 1, 2017
Nadine Davidson Individual Operational/Managerial ControlRevenue Cycle Management Director Feb 6, 2026
Donald Nevard Individual Corporate OfficerBoard Member Aug 1, 2017
Amy Dunn Individual Corporate OfficerPresident Aug 1, 2017

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1659995116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688",
            "fax_number": "844-689-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W VANDAMENT AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994666",
            "telephone_number": "405-632-6688",
            "fax_number": "844-689-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARIETY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VARIETY CARE, INC.",
        "enumeration_date": "2020-06-01",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "NADINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "405-632-6688"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Variety Care Yukon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Variety Care Yukon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.