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BLACK OAK CLINIC LLC
NPI 1366954661
Clinic/Center in Broken Bow, OK

Active since October 26, 2017CLIA 37D2141909 · Waiver
110 W 1ST ST, BROKEN BOW, OK 74728(580) 584-3099(580) 584-3097 Get Directions Write a Review

NPPES record last updated: August 7, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 7, 2018, Jun 16, 2018, Oct 26, 2017 (3 updates tracked since 2017).

About Black Oak Clinic Llc NPPES

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

BLACK OAK CLINIC LLC (NPI 1366954661) is a healthcare organization registered as a clinic/center in Broken Bow, Oklahoma and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through December 26, 2027 and lists Megan Elizabeth Black, Owner/nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1366954661
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBLACK OAK CLINIC LLC
Location Address110 W 1ST STBroken Bow, OK 74728
Mailing Address110 W 1st StBroken Bow, OK 74728-3902 · (405) 628-8901
Phone(580) 584-3099
Fax(580) 584-3097
Organization SubpartNo
Authorized OfficialMegan Elizabeth BlackOwner/nurse Practitioner · (580) 584-3099
Enumeration DateOctober 26, 2017
Last NPPES UpdateAugust 7, 20183 updates tracked since enumeration
✔ NPI 1366954661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
110 W 1ST ST, Broken Bow, OK 74728
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Other Identifiers 1

Medicaid200740450AOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.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 37D2141909

Black Oak Clinic LLC · Broken Bow, OK
Active · expires Dec 26, 2027
CLIA Number37D2141909
Laboratory TypePractitioner Other
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorMegan E. Black
Laboratory Phone(580) 584-3099
Laboratory LocationBlack Oak Clinic LLC110 W 1st Street, Broken Bow, OK 74728
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

MRS. MEGAN ELIZABETH BLACK APRN, C-NP
Nurse Practitioner
110 W 1ST ST
BROKEN BOW, OK 74728
McCurtain County (580) 584-3099
FAMILY MEDICAL CLINIC
Family Medicine
110 W 1ST ST
BROKEN BOW, OK 74728
McCurtain County (580) 584-7210

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 Black Oak Clinic LLC's NPI number?

The NPI number for Black Oak Clinic LLC is 1366954661. It was assigned to this organization in the NPPES registry on October 26, 2017.

Where is Black Oak Clinic LLC located?

Black Oak Clinic LLC is located at 110 W 1st St, Broken Bow, OK 74728. The listed phone number is (580) 584-3099.

What is Black Oak Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Black Oak Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2141909) is associated with this NPI, valid through December 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Black Oak Clinic LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Black Oak Clinic LLC 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 Black Oak Clinic LLC was last updated on August 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.