Grace Dpc
Family Medicine in Cherokee, OK. Organization (NPI-2).
NPI number1477025658
StatusActive
Last updated in NPPESDec 12, 2025
Details
- NPI
- 1477025658
- Entity type
- Organization (NPI-2)
- Legal business name
- Grace Dpc
- Organization subpart
- No
- Enumeration date
- Dec 27, 2018
- Certification date
- Dec 12, 2025
- Last updated
- Dec 12, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
221 S Grand AveCherokee, OK 73728-2029
Phone 580-307-6263 · Fax 580-603-8602
Mailing address
221 S Grand AveCherokee, OK 73728-2029
Phone 580-307-6263 · Fax 580-603-8602
Authorized official
Niki Lewis-Wyatt
President
5803076263
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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