ELLIS FAMILY PRACTICE
NPI 1538672001
Clinic/Center - Primary Care in Shawnee, OK

Active since November 07, 2017
420 N KICKAPOO AVE, SHAWNEE, OK 74801(400) 581-6331 Get Directions Write a Review

NPPES record last updated: November 7, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Clinic/Center
  • Primary Care

About ELLIS FAMILY PRACTICE

This page provides the complete NPI Profile along with additional information for Ellis Family Practice, a primary care provider established in Shawnee, Oklahoma operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1538672001 assigned on November 2017. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Ellis Family Practice. The authorized official of this NPI record is Denise Cato (Contracting Manager)

NPI
1538672001 Verify this NPI
Provider Legal Name
JERI L ELLIS MD, MPH, PC
Other Organization Name
ELLIS FAMILY PRACTICE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
420 N KICKAPOO AVE SHAWNEE, OK 74801
Location Phone
(400) 581-6331
Mailing Address
5909 NW EXPRESSWAY STE 360 OKLAHOMA CITY, OK 73132
Mailing Phone
(405) 470-1884
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-07-2017
Last Update Date
11-07-2017
Code Navigator

A primary care provider (PCP) like Ellis Family Practice sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207QA0505XAllopathic & Osteopathic Physicians

Family Medicine
Adult Medicine

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DENISE CATO

Authorized Official Title
CONTRACTING MANAGER
Authorized Official Phone
(405) 470-1884

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Counselor (Mental Health)
420 N KICKAPOO AVE
SHAWNEE, OK 74801

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538672001, enumerated as an "organization" on November 07, 2017.

The provider is located at 420 N KICKAPOO AVE SHAWNEE, OK 74801 and the phone number is (400) 581-6331.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.