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PREMISE HEALTH - BROKEN ARROW
NPI 1861972291
Clinic/Center - Primary Care in Broken Arrow, OK

Active since August 15, 2018
1104 E KENOSHA ST, BROKEN ARROW, OK 74012(918) 994-6866(918) 994-6897 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 13, 2022, May 27, 2021, Aug 15, 2018 (3 updates tracked since 2018).

About Premise Health - Broken Arrow NPPES

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

PREMISE HEALTH - BROKEN ARROW (NPI 1861972291) is a healthcare organization registered as a primary care in Broken Arrow, Oklahoma and active in the NPI registry since August 2018. The organization lists Jonathan Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1861972291
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePREMISE HEALTH OF OKLAHOMA MEDICAL, P.C
Location Address1104 E KENOSHA STBroken Arrow, OK 74012-2067
Mailing Address5500 Maryland Way Ste 400Brentwood, TN 37027-7048
Phone(918) 994-6866
Fax(918) 994-6897
Organization SubpartNo
Authorized OfficialJonathan LeizmanPresident · (216) 479-9063
Enumeration DateAugust 15, 2018
Last NPPES UpdateOctober 13, 20223 updates tracked since enumeration
NPPES CertifiedOctober 13, 2022
✔ NPI 1861972291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1104 E KENOSHA ST, Broken Arrow, OK 74012
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Other Names 1

Doing Business AsPremise Health - Broken Arrow

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 Premise Health Of Oklahoma Medical, P.C's NPI number?

The NPI number for Premise Health Of Oklahoma Medical, P.C is 1861972291. It was assigned to this organization in the NPPES registry on August 15, 2018. The provider is doing business as Premise Health - Broken Arrow.

Where is Premise Health Of Oklahoma Medical, P.C located?

Premise Health Of Oklahoma Medical, P.C is located at 1104 E Kenosha St, Broken Arrow, OK 74012. The listed phone number is (918) 994-6866.

What is Premise Health Of Oklahoma Medical, P.C's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Premise Health Of Oklahoma Medical, P.C was last updated on October 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.