PONCA CITY PRIMARY CARE LLC
NPI 1831472620
Nurse Practitioner - Family in Ponca City, OK

Q: What is Ponca City Primary Care LLC's NPI number?

The NPI number for Ponca City Primary Care LLC is 1831472620. It was assigned to this organization in the NPPES registry on September 28, 2011.

Q: What is Ponca City Primary Care LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since September 28, 2011CLIA 37D2326953 · Waiver

417 FAIRVIEW AVE, PONCA CITY, OK 74601(580) 762-6100(580) 762-6104 Get Directions Write a Review

NPPES record last updated: September 28, 2011. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Ponca City Primary Care Llc NPPES

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

PONCA CITY PRIMARY CARE LLC (NPI 1831472620) is a healthcare organization registered as a family in Ponca City, Oklahoma and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through July 13, 2027 and lists Ahmad S Agha, President, as its authorized official.

NPPES Registry Identity

NPI1831472620

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NamePONCA CITY PRIMARY CARE LLC

Location Address417 FAIRVIEW AVEPonca City, OK 74601-1923

Mailing Address417 Fairview AvePonca City, OK 74601-1923 · (580) 762-6100 · Fax (580) 762-6104

Phone(580) 762-6100

Fax(580) 762-6104

Organization SubpartNo

Authorized OfficialAhmad S AghaPresident · (580) 762-6100

Enumeration DateSeptember 28, 2011

✔ NPI 1831472620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OK · R0050756

417 FAIRVIEW AVE, Ponca City, OK 74601

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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

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 37D2326953

Ponca City Primary Care · Ponca City, OK

Active · expires Jul 13, 2027

CLIA Number37D2326953

Laboratory TypePhysician Office

Certificate Effective DateJuly 14, 2025

Certificate Expiration DateJuly 13, 2027

Laboratory DirectorMelinda Allen

Laboratory Phone(580) 440-4141

Laboratory LocationPonca City Primary Care400 Fairview Ave, Bld 3 Ste 15, Ponca City, OK 74601

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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 Ponca City Primary Care LLC's NPI number?

The NPI number for Ponca City Primary Care LLC is 1831472620. It was assigned to this organization in the NPPES registry on September 28, 2011.

Where is Ponca City Primary Care LLC located?

Ponca City Primary Care LLC is located at 417 Fairview Ave, Ponca City, OK 74601. The listed phone number is (580) 762-6100.

What is Ponca City Primary Care LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Ponca City Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2326953) is associated with this NPI, valid through July 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ponca City Primary Care LLC was last updated on September 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.