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ANDERSON FAMILY MEDICAL CLINIC, LLC
NPI 1790398360
Clinic/Center - Health Service in Poteau, OK

Active since August 24, 2020
2505 N BROADWAY ST, POTEAU, OK 74953(918) 564-2726(918) 564-2732 Get Directions Write a Review

NPPES record last updated: July 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 17, 2022, Aug 24, 2020 (2 updates tracked since 2020).

About Anderson Family Medical Clinic, Llc NPPES

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

ANDERSON FAMILY MEDICAL CLINIC, LLC (NPI 1790398360) is a healthcare organization registered as a health service in Poteau, Oklahoma and active in the NPI registry since August 2020. The organization lists Shelly Dawn Anderson, Aprn, as its authorized official.

NPPES Registry Identity

NPI1790398360
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameANDERSON FAMILY MEDICAL CLINIC, LLC
Location Address2505 N BROADWAY STPoteau, OK 74953-2050
Mailing Address2505 N Broadway StPoteau, OK 74953-2050 · (918) 564-2726 · Fax (918) 564-2732
Phone(918) 564-2726
Fax(918) 564-2732
Organization SubpartNo
Authorized OfficialShelly Dawn AndersonAprn · (918) 564-2726
Enumeration DateAugust 24, 2020
Last NPPES UpdateJuly 17, 20222 updates tracked since enumeration
NPPES CertifiedJuly 17, 2022
✔ NPI 1790398360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
2505 N BROADWAY ST, Poteau, OK 74953
Open in Google Maps ↗

Other Identifiers 1

Medicaid200571200AOK

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 37D2188807

Anderson Family Medical Clinic, LLC · Poteau, OK
Expired · Jul 21, 2026
CLIA Number37D2188807
Laboratory TypePractitioner Other
Certificate Effective DateJuly 22, 2024
Certificate Expiration DateJuly 21, 2026
Laboratory DirectorShelly D. Anderson
Laboratory Phone(918) 385-1544
Laboratory LocationAnderson Family Medical Clinic, LLC2104 N Broadway St, Ste A, Poteau, OK 74953
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MRS. AMBER MAE COLLINS B.S.
Counselor (Mental Health)
2505 N BROADWAY ST
POTEAU, OK 74953
Le Flore County (918) 635-5082
MS. SHERRY RENEE WARD B.S.
Counselor (Mental Health)
2505 N BROADWAY ST
POTEAU, OK 74953
Le Flore County (918) 635-5082
SEQUOYAH COUNSELING SERVICES OF OKLAHOMA, INC.
Community/Behavioral Health
2505 N BROADWAY ST
POTEAU, OK 74953
Le Flore County (918) 635-5082
SHERRY BUZZARD
Behavior Analyst
2505 N BROADWAY ST
POTEAU, OK 74953
Le Flore County (918) 721-0380
HELEN WESTBROOK
Psychologist (Rehabilitation)
2505 N BROADWAY ST
POTEAU, OK 74953
Le Flore County (580) 380-1725

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 Anderson Family Medical Clinic, LLC's NPI number?

The NPI number for Anderson Family Medical Clinic, LLC is 1790398360. It was assigned to this organization in the NPPES registry on August 24, 2020.

Where is Anderson Family Medical Clinic, LLC located?

Anderson Family Medical Clinic, LLC is located at 2505 N Broadway St, Poteau, OK 74953. The listed phone number is (918) 564-2726.

What is Anderson Family Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Anderson Family Medical Clinic, LLC was last updated on July 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.