CLINIC AT 410 PLLC
NPI 1144065012
Nurse Practitioner - Family in Kingston, OK

Q: What is Clinic At 410 PLLC's NPI number?

The NPI number for Clinic At 410 PLLC is 1144065012. It was assigned to this organization in the NPPES registry on July 1, 2024.

Q: What is Clinic At 410 PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since July 01, 2024

410 HWY 70, KINGSTON, OK 73439(580) 565-9975(888) 241-2340 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 20, 2025, Sep 5, 2024, Jul 1, 2024 (3 updates tracked since 2024).

On this page

About Clinic At 410 Pllc NPPES

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

CLINIC AT 410 PLLC (NPI 1144065012) is a healthcare organization registered as a family in Kingston, Oklahoma and active in the NPI registry since July 2024. The organization lists Tressa Antionette Matchen, Fnp-bc, as its authorized official.

NPPES Registry Identity

NPI1144065012

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameCLINIC AT 410 PLLC

Location Address410 HWY 70Kingston, OK 73439

Mailing Address410 Highway 70 WKingston, OK 73439-8237 · (580) 565-9975 · Fax (888) 241-2340

Phone(580) 565-9975

Fax(888) 241-2340

Organization SubpartNo

Authorized OfficialTressa Antionette MatchenFnp-bc · (580) 565-9975

Enumeration DateJuly 1, 2024

Last NPPES UpdateFebruary 25, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 25, 2026

✔ NPI 1144065012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

410 HWY 70, Kingston, OK 73439

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2308503

Clinic At 410 PLLC · Kingston, OK

Expired · Jul 29, 2026

CLIA Number37D2308503

Laboratory TypeIndependent

Certificate Effective DateJuly 30, 2024

Certificate Expiration DateJuly 29, 2026

Laboratory DirectorTressa Matchen

Laboratory Phone(580) 565-9975

Laboratory LocationClinic At 410 PLLC410 Hwy 70, Kingston, OK 73439

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Clinic At 410 PLLC's NPI number?

The NPI number for Clinic At 410 PLLC is 1144065012. It was assigned to this organization in the NPPES registry on July 1, 2024.

Where is Clinic At 410 PLLC located?

Clinic At 410 PLLC is located at 410 Hwy 70, Kingston, OK 73439. The listed phone number is (580) 565-9975.

What is Clinic At 410 PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

What insurance does Clinic At 410 PLLC accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Clinic At 410 PLLC 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 Clinic At 410 PLLC was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.