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CRESTCARE FAMILY MEDICINE,PLLC
NPI 1174139554
Family Medicine in Broken Arrow, OK

Active since September 21, 2020
817 S ELM PL STE 104, BROKEN ARROW, OK 74012(918) 251-9698(405) 241-9022 Get Directions Write a Review

NPPES record last updated: September 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Crestcare Family Medicine,pllc NPPES

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

CRESTCARE FAMILY MEDICINE,PLLC (NPI 1174139554) is a healthcare organization registered as a family medicine in Broken Arrow, Oklahoma and active in the NPI registry since September 2020. The organization lists Gaurangi M Anklesaria, Owner, as its authorized official.

NPPES Registry Identity

NPI1174139554
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCRESTCARE FAMILY MEDICINE,PLLC
Location Address817 S ELM PL STE 104Broken Arrow, OK 74012-5369
Mailing Address817 S Elm Pl Ste 104Broken Arrow, OK 74012-5369 · (918) 251-9698 · Fax (405) 241-9022
Phone(918) 251-9698
Fax(405) 241-9022
Organization SubpartNo
Authorized OfficialGaurangi M AnklesariaOwner · (918) 251-9698
Enumeration DateSeptember 21, 2020
NPPES CertifiedSeptember 21, 2020
✔ NPI 1174139554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
817 S ELM PL STE 104, Broken Arrow, OK 74012
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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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA LYNN BURNETTE BCBA
Behavior Analyst
817 S ELM PL STE 104
BROKEN ARROW, OK 74012
Tulsa County (918) 928-5437
TARRA LYNN WILSON RBT
Behavior Technician
817 S ELM PL STE 104
BROKEN ARROW, OK 74012
Tulsa County (918) 928-5437

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 Crestcare Family Medicine,pllc's NPI number?

The NPI number for Crestcare Family Medicine,pllc is 1174139554. It was assigned to this organization in the NPPES registry on September 21, 2020.

Where is Crestcare Family Medicine,pllc located?

Crestcare Family Medicine,pllc is located at 817 S Elm Pl Ste 104, Broken Arrow, OK 74012. The listed phone number is (918) 251-9698.

What is Crestcare Family Medicine,pllc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Crestcare Family Medicine,pllc was last updated on September 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.