NPIMap

Organization Active NPI

Windsor Park Medical Clinic, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1699823617
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WINDSOR PARK MEDICAL CLINIC, LLC
Practice address
3625 N Meridian Ave
Oklahoma City, OK 73112-2813
Phone
(405) 605-5415
Fax
(405) 605-5310
NPI assigned
Jan 8, 2007
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Mr. Kehdinga NukunaNPI 1073172607
Title
Owner
Phone
(405) 605-5415

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 Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3625 N Meridian Ave
Oklahoma City, OK 73112-2813

Mailing address

3625 N Meridian Ave
Oklahoma City, OK 73112-2813
Phone (405) 605-5415

Other identifiers 2

IdentifierTypeStateIssuer
200029970BMedicaidOK
37D1027083OtherOKCLIA #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050601001022 OK Part B Supplier - Clinic/Group Practice 4385686278 Receives reassigned benefits from 7 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1699823617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 N MERIDIAN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122813",
            "telephone_number": "405-605-5415",
            "fax_number": "405-605-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 N MERIDIAN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122813",
            "telephone_number": "405-605-5415",
            "fax_number": "405-605-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR PARK MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "NUKUNA",
        "authorized_official_first_name": "KEHDINGA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-605-5415",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029970B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "37D1027083",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; 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.