FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC - NPI 1982267910

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

On this page

About Family Health Center Of Southern Oklahoma Inc NPPES

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

FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC (NPI 1982267910) is a healthcare organization registered as a federally qualified health center (fqhc) in Kingston, Oklahoma and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through July 22, 2027 and lists Ashley Wells, Credentialing Officer, as its authorized official.

NPPES Registry Identity

NPI1982267910

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameFAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA INC

Location Address21 N MAIN STKingston, OK 73439-6562

Mailing Address610 E 24th StTishomingo, OK 73460-3245 · (580) 371-2343 · Fax (580) 371-3614

Phone(580) 564-7885

Fax(580) 564-7902

Organization SubpartYes

Authorized OfficialAshley WellsCredentialing Officer · (580) 387-0509

Enumeration DateApril 16, 2019

Last NPPES UpdateAugust 21, 20242 updates tracked since enumeration

NPPES CertifiedAugust 21, 2024

✔ NPI 1982267910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

21 N MAIN ST, Kingston, OK 73439

Open in Google Maps ↗

Other Identifiers 1

Medicaid200018910GOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

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 37D2169578

Family Health Center Of Southern Ok · Kingston, OK

Active · expires Jul 22, 2027

CLIA Number37D2169578

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJuly 23, 2025

Certificate Expiration DateJuly 22, 2027

Laboratory DirectorPaul A. Reel

Laboratory Phone(580) 564-7885

Laboratory LocationFamily Health Center Of Southern Ok21 N Main, Kingston, OK 73439

CLIA data matches this NPI record on: Address Name Phone

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

Other Providers at the Same Location NPPES 5

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

CRAIG MICHAEL COUVILLON MD

Internal Medicine