| Wellspring Family Clinic | |
|
1081 N. Birch Ave Broken Arrow OK 74012-0000 | |
| (918) 461-0422 | |
| (918) 461-0428 |
| Full Name | Wellspring Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1081 N. Birch Ave, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Kristi Gene Sager (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 9186930834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Family Clinic 1081 N. Birch Ave Broken Arrow OK 74012 Ph: (918) 693-0834 | Wellspring Family Clinic 1081 N. Birch Ave Broken Arrow OK 74012-0000 Ph: (918) 461-0422 |
| NPI Number | 1033526611 |
|---|---|
| Provider Enumeration Date | 07/16/2014 |
| Last Update Date | 07/24/2023 |
| Medicare PECOS PAC ID | 9638391782 |
|---|---|
| Medicare Enrollment ID | O20141105002038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033526611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | R0075262 (Oklahoma) | Primary |
| Provider Name | Kristi G Sager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033182258 PECOS PAC ID: 5496713190 Enrollment ID: I20051022000183 |
| Provider Name | Matthew D Tucker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760473995 PECOS PAC ID: 1153337092 Enrollment ID: I20060301000416 |
| Provider Name | Cynthia A Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801133772 PECOS PAC ID: 3678727146 Enrollment ID: I20130208000458 |
| Provider Name | Sheila Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508224882 PECOS PAC ID: 2062718620 Enrollment ID: I20160308000288 |
| Provider Name | Stephanie Keesee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699150052 PECOS PAC ID: 7618257858 Enrollment ID: I20161206001259 |
| Provider Name | Shawn D Sager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639692254 PECOS PAC ID: 4688949209 Enrollment ID: I20171009000820 |
| Provider Name | Kama R Gettings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477072460 PECOS PAC ID: 0648536466 Enrollment ID: I20171113000131 |
| Provider Name | Laura M Burcham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679227193 PECOS PAC ID: 0941695217 Enrollment ID: I20220323001692 |
| Provider Name | Heather Leah Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699483008 PECOS PAC ID: 3577934934 Enrollment ID: I20230123000042 |
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