Sunnylane Medical Clinic LLC
NPI 1255922811ActiveOrganization· Family Medicine· Del City, OK
Family Medicine in Del City, Oklahoma, registered in NPPES in January 2021. The authorized official on file is Braden Peterson, NP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255922811 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 27, 2021 |
| Last updated in NPPES | Aug 14, 2023 |
| Certified by provider | Aug 14, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center, Urgent Care | 261QU0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OK) |
|---|
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