Provider Demographics
NPI:1104418151
Name:CARE PATHWAYS, LLC
Entity type:Organization
Organization Name:CARE PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-928-2727
Mailing Address - Street 1:2910 ADAMS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1023
Mailing Address - Country:US
Mailing Address - Phone:405-928-2727
Mailing Address - Fax:405-928-2720
Practice Address - Street 1:330 S 5TH ST STE 206
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5861
Practice Address - Country:US
Practice Address - Phone:405-928-2727
Practice Address - Fax:405-928-2720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE