CHOCTAW HEALTH & WELLNESS CLINIC, LLC
NPI 1457013328
Nurse Practitioner - Family in Choctaw, OK
About Choctaw Health & Wellness Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHOCTAW HEALTH & WELLNESS CLINIC, LLC (NPI 1457013328) is a healthcare organization registered as a family in Choctaw, Oklahoma and active in the NPI registry since October 2021. The organization lists Kimberly Khan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Choctaw Health & Wellness Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Choctaw Health & Wellness Clinic, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Choctaw Health & Wellness Clinic, LLC's NPI number?
The NPI number for Choctaw Health & Wellness Clinic, LLC is 1457013328. It was assigned to this organization in the NPPES registry on October 8, 2021.
Where is Choctaw Health & Wellness Clinic, LLC located?
Choctaw Health & Wellness Clinic, LLC is located at 14890 SE 29th St Suite 106, Choctaw, OK 73020. The listed phone number is (405) 281-1027.
What is Choctaw Health & Wellness Clinic, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Choctaw Health & Wellness Clinic, LLC enrolled in Medicare?
Yes. Choctaw Health & Wellness Clinic, LLC is registered in the Medicare PECOS enrollment system.
When is Choctaw Health & Wellness Clinic, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oklahoma, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Choctaw Health & Wellness Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Choctaw Health & Wellness Clinic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Choctaw Health & Wellness Clinic, LLC was last updated on October 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Choctaw Health & Wellness Clinic, Llc · NPI 1457013328
Family organization in Choctaw, Oklahoma. Organization record, active in the CMS NPPES registry since October 8, 2021.
## Identity
- **NPI:** 1457013328 (Entity type: Organization)
- **Enumerated:** October 8, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kimberly Khan, OWNER
## Practice location
- **Address:** 14890 SE 29TH ST, SUITE 106, Choctaw, OK 73020
- **Phone:** (405) 281-1027 · **Fax:** (405) 281-1006
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Oklahoma, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 8, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1457013328) · Data from the CMS NPPES public registry.