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SUPREME HEALTHCARE PLLC
NPI 1326631862
Family Medicine in Tulsa, OK

Active since February 16, 2021
4619 S HARVARD AVE STE 100, TULSA, OK 74135(918) 619-9441(918) 619-9442 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 15, 2021, Mar 2, 2021, Feb 16, 2021 (3 updates tracked since 2021).

About Supreme Healthcare Pllc NPPES

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

SUPREME HEALTHCARE PLLC (NPI 1326631862) is a healthcare organization registered as a family medicine in Tulsa, Oklahoma and active in the NPI registry since February 2021. The organization lists Kandy Kay Keeney, Manager, as its authorized official.

NPPES Registry Identity

NPI1326631862
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSUPREME HEALTHCARE PLLC
Location Address4619 S HARVARD AVE STE 100Tulsa, OK 74135-2921
Mailing Address9521 Riverside Pkwy Ste BTulsa, OK 74137-7422 · (918) 845-5498
Phone(918) 619-9441
Fax(918) 619-9442
Organization SubpartNo
Authorized OfficialKandy Kay KeeneyManager · (918) 845-5498
Enumeration DateFebruary 16, 2021
Last NPPES UpdateDecember 15, 20213 updates tracked since enumeration
NPPES CertifiedDecember 15, 2021
✔ NPI 1326631862 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.

4619 S HARVARD AVE STE 100, Tulsa, OK 74135
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Other Identifiers 1

Medicaid200993730OK

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

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 Supreme Healthcare PLLC's NPI number?

The NPI number for Supreme Healthcare PLLC is 1326631862. It was assigned to this organization in the NPPES registry on February 16, 2021.

Where is Supreme Healthcare PLLC located?

Supreme Healthcare PLLC is located at 4619 S Harvard Ave Ste 100, Tulsa, OK 74135. The listed phone number is (918) 619-9441.

What is Supreme Healthcare 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 Supreme Healthcare PLLC was last updated on December 15, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.