Verdigris Valley Family Medicine LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

VERDIGRIS VALLEY FAMILY MEDICINE LLC

Practice address

25965 S Highway 66 Ste B
Claremore, OK 74019-2468

Phone

(918) 550-0989

NPI assigned

Aug 7, 2020

Organization subpart

No

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

Authorized official

Name

Elizabeth Lee, PA-CNPI 1467919886

Title

Owner/ Employee

Phone

(918) 269-3693

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23238/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Elizabeth Lee

  • Physician Assistant
  • Claremore, OK
  • NPI 1467919886
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1699385278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25965 S HIGHWAY 66 STE B",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740192468",
            "telephone_number": "918-269-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25965 S HIGHWAY 66 STE B",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740192468",
            "telephone_number": "918-550-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDIGRIS VALLEY FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/ EMPLOYEE",
        "authorized_official_telephone_number": "918-269-3693",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vardeman Chiropractic PLLC
• Barry Keith Vardeman, D.C.
• Vascular and Vein Laser Center
• Trinity Lynn Veach
• Verdigris Public Schools
• Tasha Renee' Vicks
• Randi Vinson
• Dennis Phuoc Vo, DDS
• Jackie Marie Vo, LPC
• Debbie Sue Wade, MHR LPC

• Medical Specialty Clinic/Center in Claremore, OK
• Providers in Claremore, OK by specialty
• Medical Specialty Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.