NPIMap

Organization Active NPI

Mercy Health Love County Rural Health Clinic

  • Rural Health Clinic/Center
  • Marietta, OK
National Provider Identifier
1881723013
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERCY HEALTH LOVE COUNTY RURAL HEALTH CLINIC
Practice address
301 Wanda St
Marietta, OK 73448-1229
Phone
(580) 276-2400
Fax
(580) 276-4358
NPI assigned
Mar 5, 2007
Last updated
Aug 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
W Scott Callender
Title
Administrator
Phone
(580) 276-3347

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X OK

Addresses

Primary practice location

301 Wanda St
Marietta, OK 73448-1229

Mailing address

301 Wanda St
Marietta, OK 73448-1229
Phone (580) 276-2400

Other identifiers 1

IdentifierTypeStateIssuer
261QR1300XOtherOKTAXONOMY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000703 OK Part B Supplier - Clinic/Group Practice 4880580950 Receives reassigned benefits from 8 practitioners
Practice locations: Marietta, OK

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

300 Wanda St
Marietta, OK 73448
Phone (580) 276-2400

301 Wanda St
Marietta, OK 73448
Phone (580) 276-2400

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1881723013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 WANDA ST",
            "city": "MARIETTA",
            "state": "OK",
            "postal_code": "734481229",
            "telephone_number": "580-276-2400",
            "fax_number": "580-276-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WANDA ST",
            "city": "MARIETTA",
            "state": "OK",
            "postal_code": "734481229",
            "telephone_number": "580-276-2400",
            "fax_number": "580-276-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH LOVE COUNTY RURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "CALLENDER",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-276-3347"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "261QR1300X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.