PAULS VALLEY FAMILY HEALTHCARE APRN FNP-BC LLC
NPI 1407553597
Clinic/Center - Primary Care in Pauls Valley, OK

Active since February 09, 2023CLIA 37D2277996 · Waiver
34550 AIRLINE RD, PAULS VALLEY, OK 73075(405) 207-9238(405) 207-9240 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 23, 2023, Feb 9, 2023 (2 updates tracked since 2023).

About Pauls Valley Family Healthcare Aprn Fnp-bc Llc NPPES

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

PAULS VALLEY FAMILY HEALTHCARE APRN FNP-BC LLC (NPI 1407553597) is a healthcare organization registered as a primary care in Pauls Valley, Oklahoma and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through September 15, 2027 and lists Scotty Eugene Jackson, Nurse Practitioner / Owner, as its authorized official.

NPPES Registry Identity

NPI1407553597
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePAULS VALLEY FAMILY HEALTHCARE APRN FNP-BC LLC
Location Address34550 AIRLINE RDPauls Valley, OK 73075-9337
Mailing Address34550 Airline RdPauls Valley, OK 73075-9337 · (405) 207-9238
Fax(405) 207-9240
Organization SubpartNo
Authorized OfficialScotty Eugene JacksonNurse Practitioner / Owner · (405) 207-9238
Enumeration DateFebruary 9, 2023
Last NPPES UpdateApril 20, 20232 updates tracked since enumeration
NPPES CertifiedApril 20, 2023
NPI 1407553597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
34550 AIRLINE RD, Pauls Valley, OK 73075

Other Identifiers 1

Other211329OK · Oklahoma State Board Of Nursing

Accepted 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 37D2277996

Pauls Valley Family Healthcare Aprn, Fnp-Bc · Pauls Valley, OK
Active · expires Sep 15, 2027
CLIA Number37D2277996
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 16, 2025
Certificate Expiration DateSeptember 15, 2027
Laboratory DirectorScotty E. Jackson
Laboratory Phone(405) 207-9238
Laboratory LocationPauls Valley Family Healthcare Aprn, Fnp-Bc34550 Airline Rd, Pauls Valley, OK 73075
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

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

Nurse Practitioner (Family)
34550 AIRLINE RD
PAULS VALLEY, OK 73075

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 Pauls Valley Family Healthcare Aprn Fnp-Bc LLC's NPI number?

The NPI number for Pauls Valley Family Healthcare Aprn Fnp-Bc LLC is 1407553597. It was assigned to this organization in the NPPES registry on February 9, 2023.

Where is Pauls Valley Family Healthcare Aprn Fnp-Bc LLC located?

Pauls Valley Family Healthcare Aprn Fnp-Bc LLC is located at 34550 Airline Rd, Pauls Valley, OK 73075. The listed phone number is (405) 207-9238.

What is Pauls Valley Family Healthcare Aprn Fnp-Bc LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Pauls Valley Family Healthcare Aprn Fnp-Bc LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2277996) is associated with this NPI, valid through September 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pauls Valley Family Healthcare Aprn Fnp-Bc 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 Pauls Valley Family Healthcare Aprn Fnp-Bc 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 Pauls Valley Family Healthcare Aprn Fnp-Bc LLC was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.