Icare Center LLC
Organization Active NPI Urgent Care Clinic/Center · Harrah, OK
NPI 1881190833 · NPPES record last updated Mar 17, 2022
Key facts
- NPI
- 1881190833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- ICARE CENTER LLC
- Practice address
- 21001 SE 29TH St Unit 1
Harrah, OK 73045-6577 - Phone
- (405) 391-5526
- Fax
- (405) 391-5529
- NPI assigned
- Mar 30, 2018
- Organization subpart
- No
Authorized official
- Name
- Senthil K Raju, MD
- Title
- Provider
- Phone
- (405) 391-5526
Practitioners 69
-
Kaitlin Marie Behanna, PA-C
-
Chellie Rae Clingan, APRN,FNP-C
-
Shannon Lee Dunn, DNP, APRN-CNP, FNP-C
-
Julie Patricia Fordon, APRN, CNP
-
Kendra Kay Gore, CNP-FAMILY
-
Carolyn Ashley Hoffman, APRN, NP-C
-
Rebyl James, MSN, APRN, FNP-C
-
John Scott Jordan, APRN
-
Tina Joy, APRN
-
Chad E Knight, APRN FNP-BC
-
Tiffany Dawn Lipscomb, AANP, APRN, NP-C
-
Jeffrey C Melton, A.R.N.P.
-
Kayla Skinner, APRN
-
Derek Smith, APRN-CNP
-
Teeia Strout, FNP
-
Cinda Dawn Williams, APRN
-
Terri Nicole Williams, FNP-C
-
Drew W Woodrow, DNP, APRN, FNP-BC
-
Maggie Allen, DNP, FNP
-
Jacob Duane Boyd, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2152927 | Icare Center | Certificate of waiver | Aug 19, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180524001890 | OK | Part B Supplier - Clinic/Group Practice | 0840555777 |
Receives reassigned benefits from 69 practitioners Practice locations: Harrah, OK; Davis, OK; Oklahoma City, OK; Moore, OK; Kingfisher, OK |
National Provider Directory
Locations
21001 SE 29th St
Unit 1
Harrah, OK 73045
Phone (405) 391-5526
21001 SE 29th St
Harrah, OK 73045
Phone (405) 391-5526
21001 SE 29th St
#3
Harrah, OK 73045
Phone (405) 768-5749
102 Starlite Dr
Ste 3
Kingfisher, OK 73750
Phone (572) 200-8805
4823 S Western Ave
Oklahoma City, OK 73109
Phone (405) 669-3569
4825 S Western Ave
Oklahoma City, OK 73109
Phone (405) 900-5523
4825 S Western Ave
Ste A
Oklahoma City, OK 73109
Phone (405) 900-5523
4823 S Western Ave
Ste B
Oklahoma City, OK 73109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
21001 SE 29TH St Unit 1
Harrah, OK 73045-6577
Mailing address
21001 SE 29TH St
Harrah, OK 73045-6591
Other providers in Harrah, OK
- Harrah Whites Meadows Nursing, LLC
- David Hatrel
- Robyn Hildebrand
- Sheila Ann Howell
- Susan Kaye Hunt
- Impressions Dental of Harrah
- Regina Renee Jacobs
- Patricia Kay Jones
- Tiffany Keenum
- Lauren Kelley
All providers in Harrah, OK · Urgent Care Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.