Oologah Pediatric Care PLLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

OOLOGAH PEDIATRIC CARE PLLC

Doing business as

Central Pediatric Care

Practice address

115 W. Atlas Ave
Oologah, OK 74053-3029

Phone

(469) 915-4211

NPI assigned

Mar 6, 2024

Organization subpart

No

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

Authorized official

Name

Al Berry

Title

Manager

Phone

(469) 915-4211

Specialties & licenses 1

Addresses

Other names 1

• Central Pediatric Care Doing business as

Tax ID family

Central Pediatric Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oologah Pediatric Care, PLLC

  • Pediatric Nurse Practitioner
  • Oologah, OK
  • NPI 1164279469
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelsey Marie Lillard, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Oologah, OK
  • NPI 1871009019

  Pediatrics

  NPD

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1942067814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 SPRUCE ST",
            "city": "KIEFER",
            "state": "OK",
            "postal_code": "740413029",
            "telephone_number": "918-519-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W. ATLAS AVE",
            "city": "OOLOGAH",
            "state": "OK",
            "postal_code": "740533029",
            "telephone_number": "469-915-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OOLOGAH PEDIATRIC CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2025-09-02",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-915-4211"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Pediatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shiloh Wayne Martin, M.ED. LPC
• Hailey Elisabeth McDaniel Johnson, MSW, LCSW
• Caitlyn McLemore
• Midwest Mobile Radiographics
• Oologah Family Medicine Tana Vogele Aprn-CNP PLLC
• Oologah Pediatric Care, PLLC
• Oologah Talala Public School
• Oologah-Talala EMS District
• Oologah-Talala Public Schools
• Christopher Passmore, LPC

• Pediatric Nurse Practitioner in Oologah, OK
• Providers in Oologah, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.