NPIMap

Organization Active NPI

Tonkawa Healthcare Systems PC

Doing business as Tonkawa Medical Clinic

  • Physician Assistant
  • Tonkawa, OK
National Provider Identifier
1942333737
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
631 Issued in OK
Legal business name
TONKAWA HEALTHCARE SYSTEMS PC
Doing business as
Tonkawa Medical Clinic
Practice address
600 E Grand Ave
Tonkawa, OK 74653-3545
Phone
(580) 628-4800
Fax
(580) 628-3655
NPI assigned
Mar 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Willie Jesse Street, PANPI 1215005244
Title
President
Phone
(580) 628-4800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 631 OK Primary

Addresses

Primary practice location

600 E Grand Ave
Tonkawa, OK 74653-3545

Mailing address

PO Box 532
Tonkawa, OK 74653-0532
Phone (580) 628-4800

Other names 1

  • TONKAWA MEDICAL CLINIC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942333737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "city": "TONKAWA",
            "state": "OK",
            "postal_code": "746530532",
            "telephone_number": "580-628-4800",
            "fax_number": "580-628-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GRAND AVE",
            "city": "TONKAWA",
            "state": "OK",
            "postal_code": "746533545",
            "telephone_number": "580-628-4800",
            "fax_number": "580-628-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONKAWA HEALTHCARE SYSTEMS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "JESSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-628-4800",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TONKAWA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tonkawa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.