ELMBROOK CLINICAL SERVICES LLC
NPI 1649951211
Nurse Practitioner - Gerontology in Ardmore, OK

Q: What is Elmbrook Clinical Services LLC's NPI number?

The NPI number for Elmbrook Clinical Services LLC is 1649951211. It was assigned to this organization in the NPPES registry on July 27, 2023.

Q: What is Elmbrook Clinical Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Active since July 27, 2023

1908 12TH AVE NW, SUITE E, ARDMORE, OK 73401(580) 226-3055(580) 226-3121 Get Directions Write a Review

NPPES record last updated: January 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 5, 2024, Jul 27, 2023 (2 updates tracked since 2023).

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About Elmbrook Clinical Services Llc NPPES

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

ELMBROOK CLINICAL SERVICES LLC (NPI 1649951211) is a healthcare organization registered as a gerontology in Ardmore, Oklahoma and active in the NPI registry since July 2023. The organization lists Tom C Coble, Sole Member/initial Manager, as its authorized official.

NPPES Registry Identity

NPI1649951211

Entity TypeOrganization

Primary Taxonomy363LG0600X

Legal Business NameELMBROOK CLINICAL SERVICES LLC

Location Address1908 12TH AVE NW, SUITE EArdmore, OK 73401-1255

Mailing Address1908 12th Ave Nw, Suite EArdmore, OK 73401-1255 · (580) 226-3055 · Fax (580) 226-3121

Phone(580) 226-3055

Fax(580) 226-3121

Organization SubpartNo

Authorized OfficialTom C CobleSole Member/initial Manager · (580) 220-7093

Enumeration DateJuly 27, 2023

Last NPPES UpdateJanuary 5, 20242 updates tracked since enumeration

NPPES CertifiedJanuary 5, 2024

✔ NPI 1649951211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

1908 12TH AVE NW, Ardmore, OK 73401

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Elmbrook Clinical Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 5 clinicians reassign Medicare billing to Elmbrook Clinical Services LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Toni Headstream, FNP-C

Nurse Practitioner

NPI 1033849963

1908 12TH AVE NW STE E
Ardmore, OK 73401

(254) 485-0338

✔ PECOS✔ Accepts MedicareSame address

Jennifer Mcdonald, PMHNP-BC

Nurse Practitioner

NPI 1639048028

1908 12TH AVE NW STE E
Ardmore, OK 73401

(580) 226-3055

✔ PECOS✔ Accepts MedicareSame address

Stephanie Hammons, APRN, FNP

Nurse Practitioner

NPI 1124648746

302 E ALLEN AVE
Davis, OK 73030

(580) 513-3504

✔ PECOS✔ Accepts Medicare21 mi

Ladonna Culp, APRN

Nurse Practitioner

NPI 1114463981

311 LAFITTE ST
Tishomingo, OK 73460

(580) 387-9006

✔ PECOS28 mi

Tamera Casady

Nurse Practitioner

NPI 1356810444

131 E 12TH ST UNIT 2542
Ada, OK 74821

(580) 235-1508

✔ PECOS✔ Accepts Medicare49 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 Elmbrook Clinical Services LLC's NPI number?

The NPI number for Elmbrook Clinical Services LLC is 1649951211. It was assigned to this organization in the NPPES registry on July 27, 2023.

Where is Elmbrook Clinical Services LLC located?

Elmbrook Clinical Services LLC is located at 1908 12th Ave NW Suite E, Ardmore, OK 73401. The listed phone number is (580) 226-3055.

What is Elmbrook Clinical Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Elmbrook Clinical Services LLC enrolled in Medicare?

Yes. Elmbrook Clinical Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elmbrook Clinical Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Elmbrook Clinical Services 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Elmbrook Clinical Services LLC was last updated on January 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.