GRAND LAKE PRIMARY CARE
NPI 1316092182
Family Medicine in Grove, OK

NPI Status: Active since January 24, 2007

Contact Information

900 E 13TH ST
SUITE 104
GROVE, OK
ZIP 74344
Phone: (918) 786-3100
Fax: (918) 786-3108

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  • Organization
  • Family Medicine
  • CLIA Number: 37D1014420
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-31-2026

About GRAND LAKE PRIMARY CARE

This page provides the complete NPI Profile along with additional information for Grand Lake Primary Care, a primary care provider established in Grove, Oklahoma operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1316092182 assigned on January 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 22021 (OK). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Grand Lake Primary Care. The authorized official of this NPI record is Dr. Renee Jean Russell M.d. (Provider)

NPI
1316092182
Provider Legal Name
RENEE J RUSSELL MD INC
Other Organization Name
GRAND LAKE PRIMARY CARE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
900 E 13TH ST SUITE 104 GROVE, OK 74344
Location Phone
(918) 786-3100
Location Fax
(918) 786-3108
Mailing Address
1110 NEO LOOP GROVE, OK 74344
Mailing Phone
(918) 786-3100
Mailing Fax
(918) 786-3108
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-24-2007
Last Update Date
11-11-2016
Code Navigator

A primary care provider (PCP) like Grand Lake Primary Care sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
22021
License State
OK
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. RENEE JEAN RUSSELL M.D.

Authorized Official Title
PROVIDER
Authorized Official Phone
(918) 786-3100

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
900522115MEDICARE ID-TYPE UNSPECIFIED (04)OKMEDICARE GROUP #
249321002MEDICARE ID-TYPE UNSPECIFIED (04)OKMEDICARE INDIVIDUAL #
H73424MEDICARE UPIN (02)OK 
100017290DMEDICAID (05)OK 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
37D1014420
Facility Type
Physician Office
Certificate Effective Date
January 01, 2025
Certificate Expiration Date
December 31, 2026
Laboratory Director
RENEE J. RUSSELL, MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Grand Lake Primary Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for GRAND LAKE PRIMARY CARE

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1316092182, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
1
Doubled → 2
Pos 4
6
Unchanged
Pos 5
0
Doubled → 0
Pos 6
9
Unchanged
Pos 7
2
Doubled → 4
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 2 + 6 + 0 + 9 + 4 + 1 + 1 + 6 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1316092182.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Internal Medicine (Cardiovascular Disease)
900 E 13TH ST, SUITE 200
GROVE, OK 74344
Family Medicine
900 E 13TH ST, 104
GROVE, OK 74344
Internal Medicine (Interventional Cardiology)
900 E 13TH ST, SUITE 200
GROVE, OK 74344
Clinic/Center
900 E 13TH ST, SUITE 201
GROVE, OK 74344
Internal Medicine
900 E 13TH ST, SUITE 101
GROVE, OK 74344
Otolaryngology
900 E 13TH ST, SUITE 102
GROVE, OK 74344
Physician Assistant
900 E 13TH ST, SUITE 101
GROVE, OK 74344
Surgery
900 E 13TH ST, SUITE 102
GROVE, OK 74344
Orthopaedic Surgery
900 E 13TH ST, SUITE 104
GROVE, OK 74344
Nurse Practitioner (Pediatrics)
900 E 13TH ST, SUITE 101
GROVE, OK 74344
Obstetrics & Gynecology
900 E 13TH ST, SUITE 205
GROVE, OK 74344
Nurse Practitioner (Obstetrics & Gynecology)
900 E 13TH ST, SUITE 205
GROVE, OK 74344
Family Medicine
900 E 13TH ST, SUITE 104
GROVE, OK 74344
Internal Medicine (Interventional Cardiology)
900 E 13TH ST, SUITE 200
GROVE, OK 74344

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316092182, enumerated as an "organization" on January 24, 2007.

The provider is located at 900 E 13TH ST SUITE 104 GROVE, OK 74344 and the phone number is (918) 786-3100.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.