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GRAND LAKE REGIONAL CARDIOLOGY SERVICES LLC
NPI 1811996861
Internal Medicine - Interventional Cardiology in Grove, OK

Active since July 20, 2005
1001 E 18TH ST, GROVE, OK 74344(918) 786-1070(918) 786-7699 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Grand Lake Regional Cardiology Services Llc NPPES

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

GRAND LAKE REGIONAL CARDIOLOGY SERVICES LLC (NPI 1811996861) is a healthcare organization registered as an interventional cardiology in Grove, Oklahoma and active in the NPI registry since July 2005. The organization lists Paul Edward Callicoat, Physician Manager, as its authorized official.

NPPES Registry Identity

NPI1811996861
Entity TypeOrganization
Primary Taxonomy207RI0011X
Legal Business NameGRAND LAKE REGIONAL CARDIOLOGY SERVICES LLC
Location Address1001 E 18TH STGrove, OK 74344-2907
Mailing AddressPo Box 452438Grove, OK 74345-2438 · (918) 786-1070 · Fax (918) 786-7699
Phone(918) 786-1070
Fax(918) 786-7699
Organization SubpartNo
Authorized OfficialPaul Edward CallicoatPhysician Manager · (918) 786-7667
Enumeration DateJuly 20, 2005
Last NPPES UpdateJuly 21, 2022
✔ NPI 1811996861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

1001 E 18TH ST, Grove, OK 74344
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Other Identifiers 1

Medicaid200046050AOK

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

Other Providers at the Same Location NPPES 17

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

LUKE R LEMING DO
Family Medicine
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243
JENNIFER DANIELLE PRENTICE APRN
Nurse Practitioner
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243
MIDWEST HOSPITAL MEDICINE ASSOCIATES PC
Hospitalist
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243
GRAND LAKE IMAGING PC
Radiology (Diagnostic Radiology)
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 221-7506
MRS. SARA MARGARET VAUGHAN PA-C
Physician Assistant
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243
MARCUS STEVEN STACY
Physical Therapy Assistant
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243
DIAGNOSTIC LABORATORY OF OKLAHOMA LLC
Clinical Medical Laboratory
1001 E 18TH ST, SUITE A
GROVE, OK 74344
Delaware County (918) 786-2243
INTEGRIS GROVE HOSPITAL
General Acute Care Hospital
1001 E 18TH ST
GROVE, OK 74344
Delaware County (918) 786-2243

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 Grand Lake Regional Cardiology Services LLC's NPI number?

The NPI number for Grand Lake Regional Cardiology Services LLC is 1811996861. It was assigned to this organization in the NPPES registry on July 20, 2005.

Where is Grand Lake Regional Cardiology Services LLC located?

Grand Lake Regional Cardiology Services LLC is located at 1001 E 18th St, Grove, OK 74344. The listed phone number is (918) 786-1070.

What is Grand Lake Regional Cardiology Services LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

When was this NPI record last updated?

The NPPES record for Grand Lake Regional Cardiology Services LLC was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.