Urgent Care Walk in Clinic LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

URGENT CARE WALK IN CLINIC LLC

Practice address

702 Bryan Dr
Suite 200
Durant, OK 74701-7030

Phone

(580) 924-4707

Fax

(580) 924-6001

NPI assigned

Jan 27, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Darrell L Ledbetter, CPM CMPCS CHM

Title

Practice Manager

Phone

(580) 924-4707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

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

• Deepak S. Jaiswal, M.D.

  • Internal Medicine Physician
  • Durant, OK
  • NPI 1386698728
  Medicare reassignment NPD

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1851781975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR",
            "address_2": "SUITE 200",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017030",
            "telephone_number": "580-924-4707",
            "fax_number": "580-924-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR",
            "address_2": "SUITE 200",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017030",
            "telephone_number": "580-924-4707",
            "fax_number": "580-924-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE WALK IN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "580-924-4707",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPM CMPCS CHM"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Valgren
• Mary Leslie Vance
• Brandi Vantress, MHPS
• Bylynn Vanzandt

• Urgent Care Clinic/Center in Durant, OK
• Providers in Durant, 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 Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.