Grand Prairie Pediatric and Allergy Clinic
NPI 1588716104ActiveOrganization· Preferred Provider Organization· Warr Acres, OK
Preferred Provider Organization in Warr Acres, Oklahoma, registered in NPPES in January 2007. The authorized official on file is Kenneth C. Jackson, MD, President.
Overview
| NPI | 1588716104 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 16, 2007 |
| Last updated in NPPES | Jul 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Preferred Provider Organization Primary | 305R00000X | — | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|