NPIMap

Organization Active NPI

Icare Center LLC

  • Urgent Care Clinic/Center
  • Harrah, OK
National Provider Identifier
1881190833
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 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
Last updated
Mar 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Senthil K Raju, MDNPI 1922009075
Title
Provider
Phone
(405) 391-5526

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

21001 SE 29TH St Unit 1
Harrah, OK 73045-6577

Mailing address

21001 SE 29TH St
Harrah, OK 73045-6591

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2152927Icare Center21001 SE 29TH St, Harrah, OK 73045Certificate of waiverAug 19, 2026

National Provider Directory

National Provider Directory

Locations

21001 SE 29th St
Unit 1
Harrah, OK 73045
Phone (405) 391-5526

102 Starlite Dr
Ste 3
Kingfisher, OK 73750
Phone (572) 200-8805

1400 SE 4th St
Ste 1
Moore, OK 73160

129 Ed Noble Pkwy
Norman, OK 73072
Phone (405) 594-5848

4823 S Western Ave
Oklahoma City, OK 73109
Phone (405) 669-3569

4823 S Western Ave
Ste B
Oklahoma City, OK 73109

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

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1881190833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 SE 29TH ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730456591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 SE 29TH ST UNIT 1",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730456577",
            "telephone_number": "405-391-5526",
            "fax_number": "405-391-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "SENTHIL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "405-391-5526",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.