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PRAIRIE GARDENS MEDICAL LLC
NPI 1669080891
General Practice in Oklahoma City, OK

Active since July 14, 2020
1213 NW 122ND ST STE 401, OKLAHOMA CITY, OK 73114(405) 962-8123(405) 962-8125 Get Directions Write a Review

NPPES record last updated: September 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 16, 2020, Sep 2, 2020, Jul 27, 2020 and 1 more (4 updates tracked since 2020).

About Prairie Gardens Medical Llc NPPES

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

PRAIRIE GARDENS MEDICAL LLC (NPI 1669080891) is a healthcare organization registered as a general practice in Oklahoma City, Oklahoma and active in the NPI registry since July 2020. The organization lists Dianne G Tupper, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1669080891
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePRAIRIE GARDENS MEDICAL LLC
Location Address1213 NW 122ND ST STE 401Oklahoma City, OK 73114-7000
Mailing Address175 Lary LnGuthrie, OK 73044-6542 · (405) 962-8123 · Fax (405) 962-8125
Phone(405) 962-8123
Fax(405) 962-8125
Organization SubpartNo
Authorized OfficialDianne G TupperManaging Partner · (405) 742-8898
Enumeration DateJuly 14, 2020
Last NPPES UpdateSeptember 16, 20204 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2020
✔ NPI 1669080891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1213 NW 122ND ST STE 401, Oklahoma City, OK 73114
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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

Other Providers at the Same Location NPPES

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

PRAIRIE GARDENS MEDICAL LLC
General Practice
1213 NW 122ND ST STE 401
OKLAHOMA CITY, OK 73114
Oklahoma County (405) 962-9123

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 Prairie Gardens Medical LLC's NPI number?

The NPI number for Prairie Gardens Medical LLC is 1669080891. It was assigned to this organization in the NPPES registry on July 14, 2020.

Where is Prairie Gardens Medical LLC located?

Prairie Gardens Medical LLC is located at 1213 NW 122nd St Ste 401, Oklahoma City, OK 73114. The listed phone number is (405) 962-8123.

What is Prairie Gardens Medical LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Prairie Gardens Medical LLC was last updated on September 16, 2020. 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.