Edmond Primary Care LLC
NPI 1770344160ActiveOrganization· Family Medicine· Edmond, OK
Family Medicine in Edmond, Oklahoma, registered in NPPES in January 2024. The authorized official on file is Amanda Bodine, PHYSICIAN ASSISTANT, Owner/Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770344160 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 22, 2024 |
| Last updated in NPPES | May 14, 2025 |
| Certified by provider | May 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
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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