1. Home
  2. Directory
  3. Oklahoma
  4. City
  5. Clinic Center
  6. NPI Profile

VARIETY CARE CROOKED OAK
NPI 1104696657
Clinic/Center - Federally Qualified Health Center (FQHC) in Oklahoma City, OK

Active since January 05, 2024
1450 S EASTERN AVE BLDG A, OKLAHOMA CITY, OK 73129(405) 632-6688 Get Directions Write a Review

NPPES record last updated: January 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Variety Care Crooked Oak NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VARIETY CARE CROOKED OAK (NPI 1104696657) is a healthcare organization registered as a federally qualified health center (fqhc) in Oklahoma City, Oklahoma and active in the NPI registry since January 2024. The organization lists Ashley Horn, Comptroller, as its authorized official.

NPPES Registry Identity

NPI1104696657
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameVARIETY CARE, INC.
Location Address1450 S EASTERN AVE BLDG AOklahoma City, OK 73129-6035
Mailing Address3000 N Grand BlvdOklahoma City, OK 73107-1818 · (405) 632-6688
Phone(405) 632-6688
Organization SubpartYes
Authorized OfficialAshley HornComptroller · (405) 632-6688
Enumeration DateJanuary 5, 2024
NPPES CertifiedJanuary 5, 2024
✔ NPI 1104696657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
1450 S EASTERN AVE BLDG A, Oklahoma City, OK 73129
Open in Google Maps ↗

Other Names 1

Doing Business AsVariety Care Crooked Oak

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Variety Care Crooked Oak is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

117

Medicare enrollment records show 117 clinicians reassign Medicare billing to Variety Care Crooked Oak, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 91 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Nurse Practitioner44
Pediatric Medicine15
Dentist13
Family Practice10
Obstetrics/Gynecology10
Mental Health Counselor9
Psychiatry4
Clinical Social Worker3
6 other specialties9

Nearest to this location (20)

See all 117
Raquel Edmondson, DNP
Nurse Practitioner
NPI 1942031802
1450 S EASTERN AVE BLDG A
Oklahoma City, OK 73129
(405) 632-6688
✔ PECOS✔ Accepts MedicareSame address
Conner Johnson, DO
Pediatric Medicine
NPI 1831683101
1450 S EASTERN AVE BLDG A
Oklahoma City, OK 73129
(405) 632-6688
✔ PECOSSame address
James Cail, D.O.
Family Practice
NPI 1669403085
3851 TINKER DIAGONAL
Del City, OK 73115
(405) 632-6688
✔ PECOS✔ Accepts Medicare1.7 mi
Nelson Agudelo-Higuita, MD
Infectious Disease
NPI 1194920074
920 STANTON L YOUNG BLVD # WP1265
Oklahoma City, OK 73104
(405) 271-6434
✔ PECOS✔ Accepts Medicare2.3 mi
Kathryn Kramer, M.D.
Obstetrics/Gynecology
NPI 1477967230
920 STANTON L YOUNG BLVD WP 2410
Oklahoma City, OK 73104
(405) 271-8787
✔ PECOS✔ Accepts Medicare2.3 mi
David Ciesla, DDS, MS
Dentist
NPI 1174665111
1201 N STONEWALL AVE
Oklahoma City, OK 73117
(405) 271-6056
✔ PECOS2.3 mi
Geneva Hirshburg, M.D.
Obstetrics/Gynecology
NPI 1154764892
800 STANTON L YOUNG ANDREW ACADEMIC TOWER, SUITE 2400
Okc, OK 73104
(405) 271-7449
✔ PECOS✔ Accepts Medicare2.4 mi
Kyle Stewart, MD
Pediatric Medicine
NPI 1457557571
1200 N PHILLIPS AVE SUITE 6100
Oklahoma City, OK 73104
(405) 271-6827
✔ PECOS2.4 mi
Pamela Miles, MD
Obstetrics/Gynecology
NPI 1619945466
825 NE 10TH ST OUPB3300
Oklahoma City, OK 73104
(405) 271-9494
✔ PECOS✔ Accepts Medicare2.4 mi
Philip Mayer, NP-C
Nurse Practitioner
NPI 1346550316
1000 N LEE AVE
Oklahoma City, OK 73102
(405) 272-6155
✔ PECOS✔ Accepts Medicare3.3 mi
Jennifer Evans, LD, RD
Registered Dietitian or Nutrition Professional
NPI 1366842676
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ Accepts Medicare3.3 mi
Mona Bahavar, DO
Pediatric Medicine
NPI 1508489642
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS3.3 mi
Brandon Baker, MD
Pediatric Medicine
NPI 1720659592
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS3.3 mi
Rachel Branton, APRN-CNP
Nurse Practitioner
NPI 1871143206
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS3.3 mi
Lisa Hays, APRN-CNP
Nurse Practitioner
NPI 1962797019
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS✔ Accepts Medicare3.3 mi
Nipun Kotha, DDS
Dentist
NPI 1043443013
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS3.3 mi
Desma Mckinney, LPC, LADC
Mental Health Counselor
NPI 1871612911
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS✔ Accepts Medicare3.3 mi
Kanita Moser, O.D.
Optometry
NPI 1073705471
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS✔ Accepts Medicare3.3 mi
Taimur Paracha, MD
Family Practice
NPI 1922348036
500 SW 44TH ST
Oklahoma City, OK 73109
(405) 632-6688
✔ PECOS✔ Accepts Medicare3.3 mi
Soichchha Baniya, DDS
Dentist
NPI 1447143599
304 S AIR DEPOT BLVD
Midwest City, OK 73110
(405) 689-5069
✔ PECOS4.1 mi
See all 117 clinicians

Source: 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 Variety Care, Inc.'s NPI number?

The NPI number for Variety Care, Inc. is 1104696657. It was assigned to this organization in the NPPES registry on January 5, 2024. The provider is doing business as Variety Care Crooked Oak.

Where is Variety Care, Inc. located?

Variety Care, Inc. is located at 1450 S Eastern Ave Bldg A, Oklahoma City, OK 73129. The listed phone number is (405) 632-6688.

What is Variety Care, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Variety Care, Inc. enrolled in Medicare?

Yes. Variety Care, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Variety Care, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 117 clinicians in 14 Medicare specialties reassign their Medicare billing to Variety Care, 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 Nurse Practitioner (44), Pediatric Medicine (15) and Dentist (13). Of these, 2 practice at this address and 91 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Variety Care, Inc. accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Variety Care, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Variety Care, Inc. was last updated on January 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.