Organization Active NPI

Parker Family Clinic PLLC

  • Family Nurse Practitioner
  • Muskogee, OK
National Provider Identifier
1669910063
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PARKER FAMILY CLINIC PLLC
Practice address
3300 Chandler Rd
Ste 105
Muskogee, OK 74403-4957
Phone
(918) 441-1365
NPI assigned
Feb 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Authorized official

Name
Gay L ParkerNPI 1104992536
Title
Owner
Phone
(918) 441-1365

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

3300 Chandler Rd
Ste 105
Muskogee, OK 74403-4957

Mailing address

3300 Chandler Rd
Ste 105
Muskogee, OK 74403-4957
Phone (918) 441-1365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170316001471 OK Part B Supplier - Clinic/Group Practice 1850676719 Receives reassigned benefits from 1 practitioner
Practice locations: Muskogee, OK

National Provider Directory

National Provider Directory

Locations

1143 N Main St
Muskogee, OK 74401
Phone (918) 681-3333

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": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1669910063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 CHANDLER RD",
            "address_2": "STE 105",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034957",
            "telephone_number": "918-441-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 CHANDLER RD",
            "address_2": "STE 105",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034957",
            "telephone_number": "918-441-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKER FAMILY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "GAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-441-1365"
    },
    "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 Muskogee, OK

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.