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

Q: What is Renee J Russell MD Inc's NPI number?

The NPI number for Renee J Russell MD Inc is 1316092182. It was assigned to this organization in the NPPES registry on January 24, 2007. The provider is doing business as Grand Lake Primary Care.

Q: What is Renee J Russell MD Inc's specialty?

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

Active since January 24, 2007

900 E 13TH ST, SUITE 104, GROVE, OK 74344(918) 786-3100(918) 786-3108 Get Directions Write a Review

NPPES record last updated: November 11, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Grand Lake Primary Care NPPES

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

GRAND LAKE PRIMARY CARE (NPI 1316092182) is a healthcare organization registered as a family medicine in Grove, Oklahoma and active in the NPI registry since January 2007. The organization lists Renee Jean Russell, Provider, as its authorized official.

NPPES Registry Identity

NPI1316092182

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameRENEE J RUSSELL MD INC

Location Address900 E 13TH ST, SUITE 104Grove, OK 74344-2975

Mailing Address1110 Neo LoopGrove, OK 74344-6046 · (918) 786-3100 · Fax (918) 786-3108

Phone(918) 786-3100

Fax(918) 786-3108

Organization SubpartNo

Authorized OfficialRenee Jean RussellProvider · (918) 786-3100

Enumeration DateJanuary 24, 2007

Last NPPES UpdateNovember 11, 2016

✔ NPI 1316092182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OK · 22021

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.

900 E 13TH ST, Grove, OK 74344

Open in Google Maps ↗

Other Names 1

Doing Business AsGrand Lake Primary Care

Other Identifiers 4

Medicare ID-Type Unspecified900522115OK · Medicare Group #

Medicare ID-Type Unspecified249321002OK · Medicare Individual #

Medicare UPINH73424OK

Medicaid100017290DOK

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 14

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

MR. PAUL EDWARD CALLICOAT JR. MD

Internal Medicine (Cardiovascular Disease)

900 E 13TH ST, SUITE 200
GROVE, OK 74344

Delaware County (918) 786-7667

RENEE J. ZARINTASH, M.D., P.L.L.C

Family Medicine

900 E 13TH ST, SUITE 104
GROVE, OK 74344

Delaware County (918) 786-3100

OSU CENTER FOR HEALTH SCIENCES

Clinic/Center

900 E 13TH ST, SUITE 201
GROVE, OK 74344

Delaware County (918) 561-8306

DR. JAMES B CHAPMAN M.D.

Internal Medicine (Interventional Cardiology)

900 E 13TH ST, SUITE 200
GROVE, OK 74344

Delaware County (918) 592-0999

REGIONAL CARDIOLOGY PA

Internal Medicine (Interventional Cardiology)

900 E 13TH ST, SUITE 200
GROVE, OK 74344

Delaware County (918) 786-7667

JANET MARY FLETCHER PA C

Physician Assistant

900 E 13TH ST, SUITE 101
GROVE, OK 74344

Delaware County (918) 786-9900

DOUGLAS ALLEN OHLSTROM M.D., F.A.C.S.

Surgery

900 E 13TH ST, SUITE 102
GROVE, OK 74344

Delaware County (918) 786-7200

ASHLEY SHELLEY

Obstetrics & Gynecology

900 E 13TH ST, SUITE 205
GROVE, OK 74344

Delaware County (918) 786-2720

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 Renee J Russell MD Inc's NPI number?

The NPI number for Renee J Russell MD Inc is 1316092182. It was assigned to this organization in the NPPES registry on January 24, 2007. The provider is doing business as Grand Lake Primary Care.

Where is Renee J Russell MD Inc located?

Renee J Russell MD Inc is located at 900 E 13th St Suite 104, Grove, OK 74344. The listed phone number is (918) 786-3100.

What is Renee J Russell MD Inc'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 Renee J Russell MD Inc was last updated on November 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.