Active NPI
Triad Complete Healthcare A06 LLC
- Primary Care Clinic/Center
- Stillwater, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- TRIAD COMPLETE HEALTHCARE A06 LLC
- Practice address
- 1411 W 12TH Ave Ste E
Stillwater, OK 74074-5425 - Phone
- (405) 650-2110
- Fax
- (405) 372-2833
- NPI assigned
- Mar 9, 2023
- Last updated
- Feb 18, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen Chad Bayer, PHARMD
- Title
- Owner
- Phone
- (405) 650-2110
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
1411 W 12TH Ave Ste E
Stillwater, OK 74074-5425
Mailing address
1220 W 12TH Ave
Stillwater, OK 74074-4400
Phone (405) 650-2110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2282725 | Triad Complete Healthcare A06, LLC | Certificate of waiver | May 24, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Triad Complete Healthcare A06 LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Nurse Practitioner
- Stroud, OK
- NPI 1285570598
Locations
1411 W 12th Ave
Ste E
Stillwater, OK 74074
Phone (405) 338-7707
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Primary Care Nurse Practitioner
- Stroud, OK
- NPI 1285570598
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Military Health Care Provider
- Lawton, OK
- NPI 1376112102
-
- Family Nurse Practitioner
- Pawnee, OK
- NPI 1063907558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739836800000",
"number": "1932809738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 W 12TH AVE",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740744400",
"telephone_number": "405-650-2110",
"fax_number": "405-372-2833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 W 12TH AVE STE E",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740745425",
"telephone_number": "405-650-2110",
"fax_number": "405-372-2833"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIAD COMPLETE HEALTHCARE A06 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-09",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A",
"authorized_official_last_name": "BAYER",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "CHAD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "405-650-2110",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.