Individual provider Active NPI

Christopher Michael Poarch, NP

  • Family Nurse Practitioner
  • Ada, OK
National Provider Identifier
1871850628
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
70689 Issued in OK
Practice address
1921 Stonecipher Blvd
Ada, OK 74820
Phone
(580) 436-3980
Fax
(580) 272-5731
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 70689 OK Primary

Addresses

Primary practice location

1921 Stonecipher Blvd
Ada, OK 74820

Mailing address

1921 Stonecipher Blvd
Ada, OK 74820
Phone (580) 436-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150112000427 TX Practitioner - Nurse Practitioner 3173773215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
70689OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health CurrentSince Aug 28, 2014 Accepting new patients
Chickasaw Nation Division of Health CurrentSince Aug 28, 2014 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center Past Accepting new patients

Locations

1001 N Country Club Rd
Ada, OK 74820
Phone (580) 421-4570

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1600 N Washington Ave
Durant, OK 74701
Phone (580) 740-0205

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Interoperability endpoints

  • Direct secure messaging: cpoarch21976@direct.chickasawnationhealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1871850628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-436-3980",
            "fax_number": "580-272-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-436-3980",
            "fax_number": "580-272-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POARCH",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "70689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.