UTICA PARK CLINIC FAMILY MEDICINE
NPI 1740787928
Clinic/Center - Rural Health in Pryor, OK

Active since April 12, 2018CLIA 37D1088768 · Waiver
1301 NE 1ST ST STE 400, PRYOR, OK 74361(918) 824-8000(918) 825-5505 Get Directions Write a Review

NPPES record last updated: June 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2019, Nov 7, 2018, Jul 27, 2018 and 2 more (5 updates tracked since 2018).

About Utica Park Clinic Family Medicine NPPES

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

UTICA PARK CLINIC FAMILY MEDICINE (NPI 1740787928) is a healthcare organization registered as a rural health in Pryor, Oklahoma and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through April 30, 2027 and lists Stephen C. Petrovich, Evp, as its authorized official.

NPPES Registry Identity

NPI1740787928
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameAHS PRYOR HOSPITAL, LLC
Location Address1301 NE 1ST ST STE 400Pryor, OK 74361
Mailing Address1301 Ne 1st St Ste 400Pryor, OK 74361-8851 · (918) 824-8000 · Fax (918) 825-5505
Fax(918) 825-5505
Organization SubpartNo
Authorized OfficialStephen C. PetrovichEvp · (615) 296-3000
Enumeration DateApril 12, 2018
Last NPPES UpdateJune 4, 20195 updates tracked since enumeration
NPI 1740787928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedClinic/CenterTaxonomy 261Q00000X
1301 NE 1ST ST STE 400, Pryor, OK 74361

Other Names 1

Doing Business AsUtica Park Clinic Family Medicine

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D1088768

Utica Park Clinic Family Medicine Ahs Pryor Hospital, LLC · Pryor, OK
Active · expires Apr 30, 2027
CLIA Number37D1088768
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorDarin Gwartney
Laboratory Phone(918) 824-7714
Laboratory LocationUtica Park Clinic Family Medicine Ahs Pryor Hospital, LLC1301 NE 1st St Ste 400, Pryor, OK 74361
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Family Medicine
1301 NE 1ST ST STE 400
PRYOR, OK 74361
Nurse Practitioner
1301 NE 1ST ST STE 400
PRYOR, OK 74361

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 Ahs Pryor Hospital, LLC's NPI number?

The NPI number for Ahs Pryor Hospital, LLC is 1740787928. It was assigned to this organization in the NPPES registry on April 12, 2018. The provider is doing business as Utica Park Clinic Family Medicine.

Where is Ahs Pryor Hospital, LLC located?

Ahs Pryor Hospital, LLC is located at 1301 NE 1st St Ste 400, Pryor, OK 74361. The listed phone number is (918) 824-8000.

What is Ahs Pryor Hospital, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Ahs Pryor Hospital, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D1088768) is associated with this NPI, valid through April 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ahs Pryor Hospital, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Ahs Pryor Hospital, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ahs Pryor Hospital, LLC was last updated on June 4, 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.