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MUSKOGEE FAMILY MEDICINE, LLC
NPI 1790891505
Family Medicine in Muskogee, OK

Active since August 22, 2006
3330 W OKMULGEE ST, MUSKOGEE, OK 74401(918) 682-4318(918) 682-0615 Get Directions Write a Review

NPPES record last updated: September 7, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Muskogee Family Medicine, Llc NPPES

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

MUSKOGEE FAMILY MEDICINE, LLC (NPI 1790891505) is a healthcare organization registered as a family medicine in Muskogee, Oklahoma and active in the NPI registry since August 2006. The organization lists Judy C. Oliver, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1790891505
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMUSKOGEE FAMILY MEDICINE, LLC
Location Address3330 W OKMULGEE STMuskogee, OK 74401-5069
Mailing Address3330 W Okmulgee StMuskogee, OK 74401-5069 · (918) 682-4318 · Fax (918) 682-0615
Phone(918) 682-4318
Fax(918) 682-0615
Organization SubpartNo
Authorized OfficialJudy C. OliverClinic Manager · (918) 682-4318
Enumeration DateAugust 22, 2006
Last NPPES UpdateSeptember 7, 2017
✔ NPI 1790891505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3330 W OKMULGEE ST, Muskogee, OK 74401
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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)

Muskogee Family Medicine, Llc 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 Muskogee Family Medicine, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Brad Mcintosh, MD
Family Practice
NPI 1659373819
3330 W OKMULGEE ST
Muskogee, OK 74401
(918) 682-4318
✔ PECOS✔ Accepts MedicareSame address
Jason Dansby, MD
Family Practice
NPI 1437151578
3330 W OKMULGEE ST
Muskogee, OK 74401
(918) 682-4318
✔ PECOS✔ Accepts MedicareSame address
Justin Roberts, NP-C
Nurse Practitioner
NPI 1962953158
333 S 38TH ST STE E
Muskogee, OK 74401
(918) 910-5391
✔ PECOS✔ Accepts Medicare0.4 mi
Evan Cole, DO
Family Practice
NPI 1710989900
6585 S YALE AVE STE 1220
Tulsa, OK 74136
(918) 502-4950
✔ PECOS✔ Accepts Medicare36 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 Muskogee Family Medicine, LLC's NPI number?

The NPI number for Muskogee Family Medicine, LLC is 1790891505. It was assigned to this organization in the NPPES registry on August 22, 2006.

Where is Muskogee Family Medicine, LLC located?

Muskogee Family Medicine, LLC is located at 3330 W Okmulgee St, Muskogee, OK 74401. The listed phone number is (918) 682-4318.

What is Muskogee Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Muskogee Family Medicine, LLC enrolled in Medicare?

Yes. Muskogee Family Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Muskogee Family Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Muskogee Family Medicine, 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. The largest specialties are Family Practice (3) and Nurse Practitioner (1). Of these, 2 practice at this address and 3 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 Muskogee Family Medicine, LLC was last updated on September 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.