| Primary Care Associates Pc | |
|
4150 Se Adams Rd Bartlesville OK 74006-8410 | |
| (918) 331-9979 | |
| (918) 331-2346 |
| Full Name | Primary Care Associates Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 4150 Se Adams Rd, Bartlesville, Oklahoma |
| Authorized Official Name and Position | Maureen Daniel (OPERATIONS MANAGER) |
| Authorized Official Contact | 9183312330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Associates Pc 4150 Se Adams Rd Bartlesville OK 74006-8410 Ph: (918) 331-9979 | Primary Care Associates Pc 4150 Se Adams Rd Bartlesville OK 74006-8410 Ph: (918) 331-9979 |
| NPI Number | 1275528630 |
|---|---|
| Provider Enumeration Date | 09/13/2005 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 9335486174 |
|---|---|
| Medicare Enrollment ID | O20190131002762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275528630 | NPI | - | NPPES |
| 100747860A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Janice C Shippy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245222538 PECOS PAC ID: 6103888433 Enrollment ID: I20041029000426 |
| Provider Name | Mark D Erhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770546640 PECOS PAC ID: 0648283937 Enrollment ID: I20060804000099 |
| Provider Name | Elizabeth Redding Sherrock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033104492 PECOS PAC ID: 0941245583 Enrollment ID: I20100708000740 |
| Provider Name | Michael Ryan Vaclaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942295308 PECOS PAC ID: 7012952658 Enrollment ID: I20100713000640 |
| Provider Name | William W Davito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164417515 PECOS PAC ID: 1850482266 Enrollment ID: I20100717000208 |
| Provider Name | Daniel J Holdman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972768919 PECOS PAC ID: 0840488813 Enrollment ID: I20101217000789 |
| Provider Name | Ellen L Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881217719 PECOS PAC ID: 0446647861 Enrollment ID: I20220503000979 |
| Provider Name | Marissa L Bernabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720697378 PECOS PAC ID: 5991153223 Enrollment ID: I20231128001601 |
| Provider Name | Allison Grayce Redding |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659152734 PECOS PAC ID: 2860841822 Enrollment ID: I20231215001887 |
| Provider Name | Amanda Gutierrez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639466899 PECOS PAC ID: 5496003121 Enrollment ID: I20240112000464 |
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