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GREEN COUNTRY INFECTIOUS DISEASE PC
NPI 1639639321
Internal Medicine - Infectious Disease in Broken Arrow, OK

Active since March 20, 2019
421 STONE WOOD DR, BROKEN ARROW, OK 74012(918) 872-8822 Get Directions Write a Review

NPPES record last updated: April 3, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 3, 2019, Mar 20, 2019 (2 updates tracked since 2019).

About Green Country Infectious Disease Pc NPPES

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

GREEN COUNTRY INFECTIOUS DISEASE PC (NPI 1639639321) is a healthcare organization registered as an infectious disease in Broken Arrow, Oklahoma and active in the NPI registry since March 2019. The organization maintains a secondary practice location in Broken Arrow and lists Janice L Bracken, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1639639321
Entity TypeOrganization
Primary Taxonomy207RI0200X
Legal Business NameGREEN COUNTRY INFECTIOUS DISEASE PC
Location Address421 STONE WOOD DRBroken Arrow, OK 74012-1026
Mailing Address5908 S 298th East AveBroken Arrow, OK 74014-8405 · (918) 872-8822 · Fax (918) 872-8823
Phone(918) 872-8822
Organization SubpartNo
Authorized OfficialJanice L BrackenCredentialing · (918) 448-6160
Enumeration DateMarch 20, 2019
Last NPPES UpdateApril 3, 20192 updates tracked since enumeration
✔ NPI 1639639321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
421 STONE WOOD DR, Broken Arrow, OK 74012
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Secondary Practice Location 1

Location 15908 S 298th East AveBroken Arrow, OK 74014-8405 · Phone (918) 872-8822 · Fax (918) 872-8823

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Green Country Infectious Disease Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Green Country Infectious Disease PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Winter Carson, APRN
Nurse Practitioner
NPI 1447031596
421 STONE WOOD DR
Broken Arrow, OK 74012
(918) 872-8822
✔ PECOS✔ Accepts MedicareSame address
Chandler Sweetwood
Nurse Practitioner
NPI 1578261939
6151 S YALE AVE STE 100A
Tulsa, OK 74136
(918) 494-8500
✔ PECOS✔ Accepts Medicare7.1 mi
Cheryl Sauvie, FNP
Nurse Practitioner
NPI 1518346626
1809 E 13TH ST STE 400
Tulsa, OK 74104
(918) 599-8200
✔ PECOS✔ Accepts Medicare11 mi
Faisal Wasi, MD
Internal Medicine
NPI 1689672263
905 NW 5TH ST
Stigler, OK 74462
(918) 967-0072
✔ PECOS✔ Accepts Medicare67 mi

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 Green Country Infectious Disease PC's NPI number?

The NPI number for Green Country Infectious Disease PC is 1639639321. It was assigned to this organization in the NPPES registry on March 20, 2019.

Where is Green Country Infectious Disease PC located?

Green Country Infectious Disease PC is located at 421 Stone Wood Dr, Broken Arrow, OK 74012. The listed phone number is (918) 872-8822.

What is Green Country Infectious Disease PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Green Country Infectious Disease PC enrolled in Medicare?

Yes. Green Country Infectious Disease PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Green Country Infectious Disease PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Green Country Infectious Disease PC. 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. The largest specialties are Nurse Practitioner (3) and Internal Medicine (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Green Country Infectious Disease PC was last updated on April 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.