Ageless Family Medicine LLC
Organization Active NPI Family Medicine Physician · Oklahoma City, OK
NPI 1710692470 · NPPES record last updated Jan 17, 2023
Key facts
- NPI
- 1710692470
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- AGELESS FAMILY MEDICINE LLC
- Practice address
- 5300 N Meridian Ave Ste 8
Oklahoma City, OK 73112-2137 - Phone
- (405) 768-2121
- Fax
- (405) 768-2232
- NPI assigned
- Jan 17, 2023
- Organization subpart
- No
Authorized official
- Name
- Melanie Taponno, APRN
- Title
- Provider
- Phone
- (405) 512-4881
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240227001211 | OK | Part B Supplier - Clinic/Group Practice | 0042655375 |
Receives reassigned benefits from 1 practitioner Practice locations: Oklahoma City, OK |
National Provider Directory
Locations
5300 N Meridian Ave
Ste 8
Oklahoma City, OK 73112
Phone (405) 768-2121
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
5300 N Meridian Ave Ste 8
Oklahoma City, OK 73112-2137
Mailing address
1833 Olde School Rd
Edmond, OK 73012-3244
Phone (405) 512-4881
Other names
- Checkup Medical Clinic
Other providers in Oklahoma City, OK
- Comfort Onuekwuzunma Agbara
- Alison Nicole Agee
- Carson Kendall Agee
- Lindsey Agee
- Tyler Paul Agee
- Natalie Agers
- Indu Aggarwal
- Ruchi Aggarwal
- Shivaansh Aggarwal
- Agility Medical Group
All providers in Oklahoma City, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.