Organization Active NPI

Express Family Care LLC

  • Primary Care Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1861873085
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
F0613916 Issued in OK
Legal business name
EXPRESS FAMILY CARE LLC
Practice address
7117 W. Wilshire Blvd
Oklahoma City, OK 73132
Phone
(405) 470-1224
Fax
(405) 217-0063
NPI assigned
Jun 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Jimmy Lee Tisdale, APRNNPI 1477992253
Title
Owner
Phone
(405) 470-1224

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X F0613916 OK Primary

Addresses

Primary practice location

7117 W. Wilshire Blvd
Oklahoma City, OK 73132

Mailing address

7117 W Wilshire Blvd
Oklahoma City, OK 73132-5575
Phone (405) 470-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150910002607 OK Part B Supplier - Clinic/Group Practice 3072820885 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

7117 W Wilshire Blvd
Oklahoma City, OK 73132
Phone (405) 470-1224

Practitioners & affiliated clinicians

Practitioners 3

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": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1861873085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 W WILSHIRE BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731325575",
            "telephone_number": "405-470-1224",
            "fax_number": "405-217-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 W. WILSHIRE BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73132",
            "telephone_number": "405-470-1224",
            "fax_number": "405-217-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "TISDALE",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-470-1224",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "F0613916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.