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MISSION STREET MEDICAL CLINIC INC
NPI 1972600112
Family Medicine in Sapulpa, OK

Active since September 20, 2006
615 S MISSION ST STE A, SAPULPA, OK 74066(918) 224-9555(918) 224-8001 Get Directions Write a Review

NPPES record last updated: December 30, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mission Street Medical Clinic Inc NPPES

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

MISSION STREET MEDICAL CLINIC INC (NPI 1972600112) is a healthcare organization registered as a family medicine in Sapulpa, Oklahoma and active in the NPI registry since September 2006. The organization lists Dianna M Willis, Doctor, as its authorized official.

NPPES Registry Identity

NPI1972600112
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMISSION STREET MEDICAL CLINIC INC
Location Address615 S MISSION ST STE ASapulpa, OK 74066-4635
Mailing Address615 S Mission St Ste ASapulpa, OK 74066-4635 · (918) 224-9555 · Fax (918) 224-8001
Phone(918) 224-9555
Fax(918) 224-8001
Organization SubpartNo
Authorized OfficialDianna M WillisDoctor · (918) 224-9555
Enumeration DateSeptember 20, 2006
Last NPPES UpdateDecember 30, 2010
✔ NPI 1972600112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 2405
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.

615 S MISSION ST STE A, Sapulpa, OK 74066
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Other Identifiers 5

OtherC05052OK · Railroad Medicare
Medicare UPINE45378OK
Medicare PIN700522111OK
Other=========003OK · Blue Cross Blue Shield
Medicaid100739110AOK

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 2

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

DR. RYAN MICHAEL MCCRACKEN D.O.
Pediatrics
615 S MISSION ST STE A
SAPULPA, OK 74066
Creek County (918) 347-6484
RACHEL MARIE VALCARCEL RD, LD
Dietitian, Registered
615 S MISSION ST STE A
SAPULPA, OK 74066
Creek County (918) 224-9310

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 Mission Street Medical Clinic Inc's NPI number?

The NPI number for Mission Street Medical Clinic Inc is 1972600112. It was assigned to this organization in the NPPES registry on September 20, 2006.

Where is Mission Street Medical Clinic Inc located?

Mission Street Medical Clinic Inc is located at 615 S Mission St Ste A, Sapulpa, OK 74066. The listed phone number is (918) 224-9555.

What is Mission Street Medical Clinic Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Mission Street Medical Clinic Inc was last updated on December 30, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.