GRAND LAKE MEDICAL HEALTH CENTER
NPI 1063817021
Clinic/Center - Mental Health (Including Community Mental Health Center) in Pryor, OK
About Grand Lake Medical Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRAND LAKE MEDICAL HEALTH CENTER (NPI 1063817021) is a healthcare organization registered as a mental health (including community mental health center) in Pryor, Oklahoma and active in the NPI registry since November 2014. The organization lists Larry Smith, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grand Lake Medical Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
333Medicare enrollment records show 333 clinicians reassign Medicare billing to Grand Lake Medical Health Center, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 32 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 333Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Grand Lake Mental Health Center, Inc.'s NPI number?
The NPI number for Grand Lake Mental Health Center, Inc. is 1063817021. It was assigned to this organization in the NPPES registry on November 3, 2014. The provider is doing business as Grand Lake Medical Health Center.
Where is Grand Lake Mental Health Center, Inc. located?
Grand Lake Mental Health Center, Inc. is located at 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 825-1405.
What is Grand Lake Mental Health Center, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Grand Lake Mental Health Center, Inc. enrolled in Medicare?
Yes. Grand Lake Mental Health Center, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Grand Lake Mental Health Center, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 333 clinicians in 6 Medicare specialties reassign their Medicare billing to Grand Lake Mental Health Center, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (187), Clinical Social Worker (118) and Marriage and Family Therapist (15). Of these, 10 practice at this address and 32 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Grand Lake Mental Health Center, Inc. was last updated on July 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Grand Lake Medical Health Center · NPI 1063817021
Mental Health (Including Community Mental Health Center) organization in Pryor, Oklahoma. Organization record, active in the CMS NPPES registry since November 3, 2014.
## Identity
- **NPI:** 1063817021 (Entity type: Organization)
- **Enumerated:** November 3, 2014
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Legal business name:** Grand Lake Mental Health Center, Inc.
- **Organization subpart:** No
- **Authorized official:** Larry Smith, CEO
## Practice location
- **Address:** 109 N FAIRLAND ST, Pryor, OK 74361-4203
- **Phone:** (918) 825-1405
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 333 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Mental Health Counselor (187), Clinical Social Worker (118), Marriage and Family Therapist (15); 10 practice at this address and 32 within 10 miles; [full list](https://npiprofile.com/npi/1063817021/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 31, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1063817021) · Data from the CMS NPPES public registry.