Ponca City Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0050756 Issued in OK

Legal business name

PONCA CITY PRIMARY CARE LLC

Practice address

417 Fairview Ave
Ponca City, OK 74601-1923

Phone

(580) 762-6100

Fax

(580) 762-6104

NPI assigned

Sep 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ahmad S Agha, MD

Title

President

Phone

(580) 762-6100

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Physicians Urgent Care Center, Inc.

  • Family Medicine Physician
  • Ponca City, OK
  • NPI 1831204759

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1831472620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011923",
            "telephone_number": "580-762-6100",
            "fax_number": "580-762-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011923",
            "telephone_number": "580-762-6100",
            "fax_number": "580-762-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCA CITY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "AGHA",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-762-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0050756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ponca City Homecare Services Inc
• Ponca City Homecare Services Inc.
• Ponca City Immediate Care, LLC
• Ponca City Open MRI, LLC
• Ponca City Orthopaedic and Sports Medicine Clinic, Inc
• Ponca City Public School
• Ponca Sleep Interpretors LLC
• Donald D Potter, DC
• Elexas Nicole Potter
• Joanna Gayle Potter, PMHNP-BC

• Family Nurse Practitioner in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.