NPIMap

Organization Active NPI

Faith Family Clinic, PC

  • Family Nurse Practitioner
  • Jenks, OK
National Provider Identifier
1841462603
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0049248 Issued in OK
Legal business name
FAITH FAMILY CLINIC, PC
Practice address
1239 W Main St
Jenks, OK 74037-2311
Phone
(918) 291-0004
Fax
(918) 296-3911
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Patti Wheaton, ARNPNPI 1669569000
Title
Owner
Phone
(918) 291-0004

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X R0049248 OK Primary
Women's Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LW0102X R0049248 OK

Addresses

Primary practice location

1239 W Main St
Jenks, OK 74037-2311

Mailing address

1239 W Main St
Jenks, OK 74037-2311
Phone (918) 291-0004

Other identifiers 1

IdentifierTypeStateIssuer
2000065310BOtherOKINSURE OKLAHOMA

National Provider Directory

National Provider Directory

Locations

1239 W Main St
Jenks, OK 74037
Phone (918) 291-0004

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBEFCD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1841462603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-291-0004",
            "fax_number": "918-296-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-291-0004",
            "fax_number": "918-296-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH FAMILY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "WHEATON",
        "authorized_official_first_name": "PATTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-291-0004",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0049248",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R0049248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURE OKLAHOMA",
            "identifier": "2000065310B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenks, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.