Medwise LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MEDWISE LLC

Practice address

2550 N 9TH St
Broken Arrow, OK 74012-2897

Phone

(918) 727-2850

NPI assigned

Feb 4, 2025

Organization subpart

Yes

Parent organization

MEDWISE LLCAs reported in NPPES

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

Authorized official

Name

Dennis Sidney Blackstad, MD

Title

President

Phone

(918) 605-6582

Specialties & licenses 1

Addresses

Other names 1

• MedWise LLC - Broken Arrow East Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Medwise LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Medwise LLC

  • Urgent Care Clinic/Center
  • Coweta, OK
  • NPI 1629604434
  NPPES parent name

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1730993460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12902 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741346712",
            "telephone_number": "918-994-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122897",
            "telephone_number": "918-727-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWISE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDWISE LLC",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "BLACKSTAD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "SIDNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-605-6582",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedWise LLC - Broken Arrow East",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Urgent Care Clinic/Center in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Urgent Care Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.