Arkansas Clinical Management, LLC

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

ARKANSAS CLINICAL MANAGEMENT, LLC

Practice address

4301 NW 63Rd St Ste 107
Corporate Office
Oklahoma City, OK 73116-1548

Phone

(405) 593-0583

Fax

(405) 276-5703

NPI assigned

Apr 1, 2019

Organization subpart

No

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

Authorized official

Name

Jeanette McCollom

Title

Owner

Phone

(405) 513-4522

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1801358791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NW 63RD ST STE 107",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161548",
            "telephone_number": "405-593-0583",
            "fax_number": "405-276-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NW 63RD ST STE 107",
            "address_2": "CORPORATE OFFICE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161548",
            "telephone_number": "405-593-0583",
            "fax_number": "405-276-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS CLINICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "MCCOLLOM",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-513-4522"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prevention Professional in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Prevention Professional in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.