| Arkansas Verdigris Valley Health Centers, Inc. | |
|
505 S Main Porter OK 74454 | |
| (918) 483-0111 | |
| (918) 483-0112 |
| Full Name | Arkansas Verdigris Valley Health Centers, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 505 S Main, Porter, Oklahoma |
| Authorized Official Name and Position | Sonya L Smith (CEO) |
| Authorized Official Contact | 9184830111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arkansas Verdigris Valley Health Centers, Inc. Po Box 334 Porter OK 74454-0334 Ph: (918) 483-0213 | Arkansas Verdigris Valley Health Centers, Inc. 505 S Main Porter OK 74454 Ph: (918) 483-0111 |
| NPI Number | 1083740047 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 07/06/2021 |
| Medicare PECOS PAC ID | 2961594916 |
|---|---|
| Medicare Enrollment ID | O20070822000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083740047 | NPI | - | NPPES |
| 200109570A | Medicaid | OK |
| Provider Name | John E Fell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629091640 PECOS PAC ID: 0547231391 Enrollment ID: I20040804000950 |
| Provider Name | Ashley N Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003850132 PECOS PAC ID: 1153344999 Enrollment ID: I20060118000086 |
| Provider Name | Bryan Kent Ledbetter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194807024 PECOS PAC ID: 5597823716 Enrollment ID: I20081016000447 |
| Provider Name | Shelly Carlton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275088254 PECOS PAC ID: 2062778343 Enrollment ID: I20171102003080 |
| Provider Name | Jennifer Lyn Stickelmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548730559 PECOS PAC ID: 1052650389 Enrollment ID: I20190305001266 |
| Provider Name | Teresa Melinda James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811529209 PECOS PAC ID: 1850716481 Enrollment ID: I20200730000184 |
| Provider Name | Cassandra Brillhart-green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932776390 PECOS PAC ID: 2062817083 Enrollment ID: I20210828000293 |
| Provider Name | Jessica Dixon-neal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124697511 PECOS PAC ID: 9032557475 Enrollment ID: I20240404002701 |
| Provider Name | April D Eavers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356922330 PECOS PAC ID: 8123469889 Enrollment ID: I20240918001451 |