| Access Medical Center | |
|
16205 N Pennsylvania Ave Edmond OK 73013-7325 | |
| (480) 776-1600 | |
| (480) 776-0025 |
| Full Name | Access Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 16205 N Pennsylvania Ave, Edmond, Oklahoma |
| Authorized Official Name and Position | John Julian (PRESIDENT & CEO) |
| Authorized Official Contact | 4807761600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Access Medical Center 2550 N Thunderbird Cir Ste 303 Mesa AZ 85215-1219 Ph: (480) 776-1600 | Access Medical Center 16205 N Pennsylvania Ave Edmond OK 73013-7325 Ph: (480) 776-1600 |
| NPI Number | 1104056365 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 05/13/2020 |
| Medicare PECOS PAC ID | 4082753918 |
|---|---|
| Medicare Enrollment ID | O20100830000840 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104056365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Lenard B Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225017270 PECOS PAC ID: 6709799208 Enrollment ID: I20031111000194 |
| Provider Name | James J Wolfe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255399317 PECOS PAC ID: 1557260874 Enrollment ID: I20040122000277 |
| Provider Name | Jefferson Loyd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942268016 PECOS PAC ID: 2769384536 Enrollment ID: I20040122000619 |
| Provider Name | Mary Sue Kendrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598705626 PECOS PAC ID: 8921991803 Enrollment ID: I20040326001115 |
| Provider Name | Douglas R Banning |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356477681 PECOS PAC ID: 6608863287 Enrollment ID: I20040427000371 |
| Provider Name | Gregory W Fairlie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700874914 PECOS PAC ID: 4981691391 Enrollment ID: I20040428000437 |
| Provider Name | Steven Andrew Egleston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508838038 PECOS PAC ID: 7315937018 Enrollment ID: I20040514000702 |
| Provider Name | Derrick V Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982682936 PECOS PAC ID: 1456335710 Enrollment ID: I20040615000651 |
| Provider Name | Michael W Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063491801 PECOS PAC ID: 0042294340 Enrollment ID: I20040615000869 |
| Provider Name | Hetlevia Vilar-jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093755266 PECOS PAC ID: 9537147830 Enrollment ID: I20040713000314 |
| Provider Name | Dawn Michele Lovins |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811987712 PECOS PAC ID: 8820060536 Enrollment ID: I20040811001278 |
| Provider Name | Christopher C Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154311959 PECOS PAC ID: 1850367525 Enrollment ID: I20040903000243 |
| Provider Name | Gordon Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720013311 PECOS PAC ID: 3678549136 Enrollment ID: I20040907000363 |
| Provider Name | Thomas A Schooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033119805 PECOS PAC ID: 9032186135 Enrollment ID: I20040916000465 |
| Provider Name | Brent D Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093793358 PECOS PAC ID: 3870556996 Enrollment ID: I20041110000143 |
| Provider Name | Sheila J Stanek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477531747 PECOS PAC ID: 5496710592 Enrollment ID: I20041201000086 |
| Provider Name | Darrel L Stout |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356362073 PECOS PAC ID: 8729044201 Enrollment ID: I20041207000127 |
| Provider Name | Teresa A Folger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881613677 PECOS PAC ID: 6800843095 Enrollment ID: I20050404000264 |
| Provider Name | Steven D King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225090558 PECOS PAC ID: 0042255846 Enrollment ID: I20050622000891 |
| Provider Name | Rhonda A Sparks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043288822 PECOS PAC ID: 8628004058 Enrollment ID: I20050715001018 |
| Provider Name | Larry Lee Ruffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396790143 PECOS PAC ID: 7719900620 Enrollment ID: I20060124000192 |
| Provider Name | Barbara A Rygiel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730192808 PECOS PAC ID: 1557385994 Enrollment ID: I20060124000699 |
| Provider Name | Steven Nussbaum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013987288 PECOS PAC ID: 6800800384 Enrollment ID: I20060207000161 |
| Provider Name | Rita S Westenhaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639141724 PECOS PAC ID: 8123071586 Enrollment ID: I20060504000488 |
| Provider Name | Russell R Rooms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316982887 PECOS PAC ID: 6406859768 Enrollment ID: I20060807000385 |
| Provider Name | George Rodney Petry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316969355 PECOS PAC ID: 7012911381 Enrollment ID: I20061030000597 |
| Provider Name | Matthew J Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306857123 PECOS PAC ID: 5597664136 Enrollment ID: I20070323000436 |
| Provider Name | Daniel Lee Nicoll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487625505 PECOS PAC ID: 1355446220 Enrollment ID: I20070420000540 |
| Provider Name | Thomas B Atkinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417942020 PECOS PAC ID: 4880793587 Enrollment ID: I20070621000048 |
| Provider Name | Bryan V Marsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033258959 PECOS PAC ID: 7719074400 Enrollment ID: I20071026000627 |
| Provider Name | Roger A Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871777987 PECOS PAC ID: 0941387575 Enrollment ID: I20080408000068 |
| Provider Name | Barbara M Heying |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750459954 PECOS PAC ID: 1658441787 Enrollment ID: I20080602000560 |
| Provider Name | Kathleen C Rooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932351871 PECOS PAC ID: 3173686094 Enrollment ID: I20090120000212 |
| Provider Name | William Lee Welden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124022140 PECOS PAC ID: 2466501994 Enrollment ID: I20090512000587 |
| Provider Name | Loring Barwick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700837986 PECOS PAC ID: 7719886704 Enrollment ID: I20090619000093 |
| Provider Name | Craig B Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467411645 PECOS PAC ID: 6406908425 Enrollment ID: I20090722000095 |
| Provider Name | Nick L Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104055730 PECOS PAC ID: 5092861534 Enrollment ID: I20090924000140 |
| Provider Name | Gary D Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457584344 PECOS PAC ID: 6103972666 Enrollment ID: I20090924000346 |
| Provider Name | Ronald L Hay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891753414 PECOS PAC ID: 1850429309 Enrollment ID: I20100504000864 |
| Provider Name | Christopher J Delong |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649343427 PECOS PAC ID: 6608992169 Enrollment ID: I20100922000560 |
| Provider Name | Peter Paul Bullock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356506935 PECOS PAC ID: 5890988232 Enrollment ID: I20101019000311 |
| Provider Name | Kimberly S Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205149507 PECOS PAC ID: 7517146525 Enrollment ID: I20110124000457 |
| Provider Name | Donna May Devore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811216369 PECOS PAC ID: 3870774664 Enrollment ID: I20110228000320 |
| Provider Name | Mandie M Works |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851525562 PECOS PAC ID: 9032391545 Enrollment ID: I20110304000290 |
| Provider Name | Bette Bischoff Glidewell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134309933 PECOS PAC ID: 5890979264 Enrollment ID: I20110408000270 |
| Provider Name | Patrice D Pace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164561270 PECOS PAC ID: 7517136344 Enrollment ID: I20110811000235 |
| Provider Name | Kimberly A Speaks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437209723 PECOS PAC ID: 9436150869 Enrollment ID: I20110831000712 |
| Provider Name | Jared Michael Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184889446 PECOS PAC ID: 4688844210 Enrollment ID: I20110908002139 |
| Provider Name | Michael D Gorman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639332042 PECOS PAC ID: 4789858960 Enrollment ID: I20111128000628 |
| Provider Name | Matthew J Jared |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205060183 PECOS PAC ID: 2264609916 Enrollment ID: I20120119000914 |
| Provider Name | Sheleatha M Taylor Bristow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265744056 PECOS PAC ID: 2365619970 Enrollment ID: I20120123000805 |
| Provider Name | Corey D Finch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407903644 PECOS PAC ID: 3870774250 Enrollment ID: I20120202000898 |
| Provider Name | Jennifer Jill Amen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871613380 PECOS PAC ID: 1153413489 Enrollment ID: I20120302000027 |
| Provider Name | Michael S Reed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346470606 PECOS PAC ID: 1759542624 Enrollment ID: I20120420000037 |
| Provider Name | Amanda Dorough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205157179 PECOS PAC ID: 3779744545 Enrollment ID: I20120423000409 |
| Provider Name | Casey M Windrix |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215162979 PECOS PAC ID: 3173785664 Enrollment ID: I20120430000099 |
| Provider Name | Kisha Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104199470 PECOS PAC ID: 4183886047 Enrollment ID: I20120510000430 |
| Provider Name | Jeffrey W Shelton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194864074 PECOS PAC ID: 7719141639 Enrollment ID: I20120605000614 |
| Provider Name | Amy L Glasgow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659643575 PECOS PAC ID: 5890959563 Enrollment ID: I20120608000044 |
| Provider Name | Luci Ann Gratch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104102961 PECOS PAC ID: 0547424145 Enrollment ID: I20120612000107 |
| Provider Name | Charlotte A Coyner Gregory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205066958 PECOS PAC ID: 1254593312 Enrollment ID: I20120612000372 |
| Provider Name | Soisangvane Wingard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922370899 PECOS PAC ID: 6507020989 Enrollment ID: I20120614000793 |
| Provider Name | Huy Quoc Luu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124318985 PECOS PAC ID: 9830355338 Enrollment ID: I20120727000658 |
| Provider Name | Christopher L Bass |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154686152 PECOS PAC ID: 6406003912 Enrollment ID: I20120905000479 |
| Provider Name | Timothy R Newton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629332952 PECOS PAC ID: 8628226073 Enrollment ID: I20120911000017 |
| Provider Name | Christopher David Bradshaw |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255686697 PECOS PAC ID: 7416105523 Enrollment ID: I20120914000523 |
| Provider Name | Dianne Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245566181 PECOS PAC ID: 5890943856 Enrollment ID: I20120917000312 |
| Provider Name | Chelsea Rose Risinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386908960 PECOS PAC ID: 8325296270 Enrollment ID: I20120918000518 |
| Provider Name | Grand F Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730175340 PECOS PAC ID: 1052560430 Enrollment ID: I20120928000057 |
| Provider Name | Erin S Allred |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356602700 PECOS PAC ID: 1850541400 Enrollment ID: I20121017000502 |
| Provider Name | Tara D Stewart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548524093 PECOS PAC ID: 9032369525 Enrollment ID: I20121018000124 |
| Provider Name | William R Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942436209 PECOS PAC ID: 6204974330 Enrollment ID: I20121105000129 |
| Provider Name | Ben G Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093007023 PECOS PAC ID: 4486807336 Enrollment ID: I20121231000305 |
| Provider Name | Cynthia A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801133772 PECOS PAC ID: 3678727146 Enrollment ID: I20130208000458 |
| Provider Name | Aliyeah Roper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386955532 PECOS PAC ID: 8224295779 Enrollment ID: I20130212000266 |
| Provider Name | Danielle L Russell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326303280 PECOS PAC ID: 5395999544 Enrollment ID: I20130216000079 |
| Provider Name | Brittney A Summers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841530862 PECOS PAC ID: 6901044593 Enrollment ID: I20130521000006 |
| Provider Name | Cheryl C Florence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689912693 PECOS PAC ID: 3870732233 Enrollment ID: I20130614000137 |
| Provider Name | Julie C Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457615114 PECOS PAC ID: 6709025174 Enrollment ID: I20130614000255 |
| Provider Name | Courtney Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548509177 PECOS PAC ID: 7012159619 Enrollment ID: I20130812000124 |
| Provider Name | Johnie L Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104846732 PECOS PAC ID: 8426131590 Enrollment ID: I20130830000786 |
| Provider Name | Sarah E Debord |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376984492 PECOS PAC ID: 7911132816 Enrollment ID: I20131031000577 |
| Provider Name | Ciby D Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598191959 PECOS PAC ID: 2062649114 Enrollment ID: I20131216001600 |
| Provider Name | Malarie M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285056887 PECOS PAC ID: 6507096633 Enrollment ID: I20140311000536 |
| Provider Name | Julie M Hinchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992131791 PECOS PAC ID: 9931332665 Enrollment ID: I20140505001821 |
| Provider Name | Stephanie Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558786541 PECOS PAC ID: 4688899818 Enrollment ID: I20140702001011 |
| Provider Name | Brandon S. Drabek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073957049 PECOS PAC ID: 4587806377 Enrollment ID: I20140811001050 |
| Provider Name | Kori A Sauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841612025 PECOS PAC ID: 7517187834 Enrollment ID: I20141008000244 |
| Provider Name | Martin Frederick Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942595301 PECOS PAC ID: 1557532785 Enrollment ID: I20141126000833 |
| Provider Name | Merrill A Thomas |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467489872 PECOS PAC ID: 4880738913 Enrollment ID: I20141229000349 |
| Provider Name | Carol L Hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609281658 PECOS PAC ID: 7012230865 Enrollment ID: I20141231000121 |
| Provider Name | Laura B Stucki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366864373 PECOS PAC ID: 1759605132 Enrollment ID: I20150112002070 |
| Provider Name | Thomas S Boswell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831483130 PECOS PAC ID: 7113241183 Enrollment ID: I20150122000410 |
| Provider Name | Allie S Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205224482 PECOS PAC ID: 8224354964 Enrollment ID: I20150224001234 |
| Provider Name | Carlos Venegas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518115161 PECOS PAC ID: 2567502123 Enrollment ID: I20150401000431 |
| Provider Name | Julie L Hedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518245646 PECOS PAC ID: 6608047709 Enrollment ID: I20150423000352 |
| Provider Name | Ryan David Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174840045 PECOS PAC ID: 0547495491 Enrollment ID: I20150608000667 |
| Provider Name | Heather Jean Goyne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801287701 PECOS PAC ID: 0143535633 Enrollment ID: I20150812008297 |
| Provider Name | Shelly R Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053710053 PECOS PAC ID: 9638488430 Enrollment ID: I20151019000323 |
| Provider Name | Matthew Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114251238 PECOS PAC ID: 3476694910 Enrollment ID: I20151026000122 |
| Provider Name | Natalie R Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336518786 PECOS PAC ID: 8022328988 Enrollment ID: I20151104001665 |
| Provider Name | Priya John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093104176 PECOS PAC ID: 1254633449 Enrollment ID: I20160105001658 |
| Provider Name | Tina Gay Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467812156 PECOS PAC ID: 4789981234 Enrollment ID: I20160328001665 |
| Provider Name | Charles S Blagovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053763334 PECOS PAC ID: 0244527596 Enrollment ID: I20160929002245 |
| Provider Name | Hieu Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053757062 PECOS PAC ID: 4688962715 Enrollment ID: I20161005002087 |
| Provider Name | Renee Short |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588014724 PECOS PAC ID: 6608164140 Enrollment ID: I20161015000277 |
| Provider Name | Shannon L Bierig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386947570 PECOS PAC ID: 8123205416 Enrollment ID: I20170221000986 |
| Provider Name | John Eric York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821533753 PECOS PAC ID: 4688958531 Enrollment ID: I20170221002316 |
| Provider Name | Sandra Kay Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336684109 PECOS PAC ID: 6002193307 Enrollment ID: I20170515000057 |
| Provider Name | Kimberly Ann Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841749439 PECOS PAC ID: 1759658883 Enrollment ID: I20170522000745 |
| Provider Name | Kaci Marie Kretchmar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275084303 PECOS PAC ID: 7012284474 Enrollment ID: I20170606002655 |
| Provider Name | Rolanda Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528202249 PECOS PAC ID: 2466727730 Enrollment ID: I20171012001793 |
| Provider Name | Marvin R Harvey |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962761791 PECOS PAC ID: 4284990268 Enrollment ID: I20171107002399 |
| Provider Name | Christine E Noteboom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225541576 PECOS PAC ID: 7719247162 Enrollment ID: I20180205001730 |
| Provider Name | Annsley Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740717065 PECOS PAC ID: 4789947284 Enrollment ID: I20180416002018 |
| Provider Name | Ashley A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851804322 PECOS PAC ID: 8123382504 Enrollment ID: I20180511000320 |
| Provider Name | James N Cornwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669884987 PECOS PAC ID: 2860700895 Enrollment ID: I20180606001992 |
| Provider Name | Teresa Nabors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952832438 PECOS PAC ID: 8921353491 Enrollment ID: I20180625002085 |
| Provider Name | Amanda Layne Crutchfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235625146 PECOS PAC ID: 9931458213 Enrollment ID: I20180820002560 |
| Provider Name | Lisa Lakins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629483623 PECOS PAC ID: 1052664562 Enrollment ID: I20181031001068 |
| Provider Name | Courtney Michelle Froehlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932682275 PECOS PAC ID: 3274877394 Enrollment ID: I20181130000761 |
| Provider Name | Sandra Renee Dietz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306369087 PECOS PAC ID: 8123362993 Enrollment ID: I20181205001040 |
| Provider Name | Heather M Rowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285103010 PECOS PAC ID: 4284970385 Enrollment ID: I20190110001633 |
| Provider Name | Angela Jeanette Thayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841774544 PECOS PAC ID: 3779820949 Enrollment ID: I20190125000802 |
| Provider Name | Lisa L. Spence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023599768 PECOS PAC ID: 8123365178 Enrollment ID: I20190129001521 |
| Provider Name | Daniel Aaron Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003396904 PECOS PAC ID: 7719226547 Enrollment ID: I20190222000215 |
| Provider Name | Kelsey Leigh Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831654672 PECOS PAC ID: 1456691500 Enrollment ID: I20190327002017 |
| Provider Name | Ashley D Mcmains |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568933349 PECOS PAC ID: 2769722776 Enrollment ID: I20190328001518 |
| Provider Name | Susan Ann Armour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730650680 PECOS PAC ID: 5395086557 Enrollment ID: I20190416002413 |
| Provider Name | Larry Sharp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306903315 PECOS PAC ID: 3476694217 Enrollment ID: I20190708002113 |
| Provider Name | Vanessa L Meuniot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861651580 PECOS PAC ID: 4082757596 Enrollment ID: I20190911002036 |
| Provider Name | Tara Henthorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811530603 PECOS PAC ID: 8224460225 Enrollment ID: I20191113000955 |
| Provider Name | Amy Marie King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508407644 PECOS PAC ID: 9537593702 Enrollment ID: I20191220000953 |
| Provider Name | Brittney Jade Roper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740841634 PECOS PAC ID: 8527493048 Enrollment ID: I20200110000735 |
| Provider Name | Angela A Colborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508415092 PECOS PAC ID: 9234566845 Enrollment ID: I20200220001547 |
| Provider Name | Joan Elizabeth Kloske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730724063 PECOS PAC ID: 6507296365 Enrollment ID: I20200417001627 |
| Provider Name | Kristi Cooksey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265071922 PECOS PAC ID: 7315377637 Enrollment ID: I20200428000867 |
| Provider Name | Lee Sykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811506389 PECOS PAC ID: 9436577509 Enrollment ID: I20200922002472 |
| Provider Name | Matthew Scott Hamm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083058168 PECOS PAC ID: 0042530875 Enrollment ID: I20201125000470 |
| Provider Name | Jennifer Laine Mccammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043876071 PECOS PAC ID: 7214266196 Enrollment ID: I20210729003692 |
| Provider Name | Kelly Nesdahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336760081 PECOS PAC ID: 2668878281 Enrollment ID: I20210908000538 |
| Provider Name | Christopher Leo Harman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548821176 PECOS PAC ID: 2567893183 Enrollment ID: I20210909003581 |
| Provider Name | Zachary Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891369245 PECOS PAC ID: 0648678672 Enrollment ID: I20211006000576 |
| Provider Name | James Allen Roseberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700832946 PECOS PAC ID: 9537053988 Enrollment ID: I20220228002228 |
| Provider Name | Haleigh Brooke Wisotsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538818000 PECOS PAC ID: 8729475629 Enrollment ID: I20220422002541 |
| Provider Name | Debbie Helms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316491632 PECOS PAC ID: 3274815691 Enrollment ID: I20220615001270 |
| Provider Name | Crystal Marie Mapes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457951519 PECOS PAC ID: 6002295342 Enrollment ID: I20220616002675 |
| Provider Name | Kanisha Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699341834 PECOS PAC ID: 8224430152 Enrollment ID: I20220725003088 |
| Provider Name | Amanda Lin Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710646773 PECOS PAC ID: 8224412952 Enrollment ID: I20220830002635 |
| Provider Name | Deanna Lynn Scruggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740830918 PECOS PAC ID: 4880010669 Enrollment ID: I20230222002678 |
| Provider Name | Peter Phillip Studebaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770072605 PECOS PAC ID: 5890027742 Enrollment ID: I20230317001434 |
| Provider Name | Shannon Cherie Nanaeto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730963596 PECOS PAC ID: 3870947567 Enrollment ID: I20230928004040 |
| Provider Name | April Lee Leavengood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568155000 PECOS PAC ID: 3870947583 Enrollment ID: I20230929000358 |
| Provider Name | Angela Marie Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700569993 PECOS PAC ID: 2769838317 Enrollment ID: I20231102000926 |
| Provider Name | Kristina Lynn True |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750169587 PECOS PAC ID: 7416307434 Enrollment ID: I20240103000448 |
| Provider Name | Ashley Ramirez Lotfabadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326509712 PECOS PAC ID: 4789036146 Enrollment ID: I20240122001933 |
| Provider Name | Matthew Randall Faiman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184730806 PECOS PAC ID: 3072518554 Enrollment ID: I20240306000073 |
Valentine Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2308 Nw 158th St, Edmond, OK 73013 Phone: 405-887-6515 Fax: 866-707-6724 | |
Deer Creek Family Healthcare And Wellness Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19401 N. Portland, Edmond, OK 73012 Phone: 405-812-8208 | |
Mark R Lynn Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 S Bryant Ave, Suite 204a, Edmond, OK 73034 Phone: 405-359-3637 Fax: 405-359-2022 | |
Central Oklahoma Foot And Ankle Center Of Edmond Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 S Bryant Ave Ste 104, Edmond, OK 73034 Phone: 405-715-3102 Fax: 405-715-2905 | |
American Current Care P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3406 S Boulevard, Edmond, OK 73013 Phone: 405-230-9700 Fax: 405-230-9711 | |
Canyon Park Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 E 19th St, Edmond, OK 73013 Phone: 405-348-6611 Fax: 405-348-9280 | |
Eagle Community Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13800 Benson Rd, 202, Edmond, OK 73013 Phone: 405-418-3077 Fax: 405-418-3076 |