GRAND LAKE PRIMARY CARE – NPI #1316092182
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

GRAND LAKE PRIMARY CARE is a provider located in GROVE, OK. NPPES has assigned the NPI number 1316092182 to GRAND LAKE PRIMARY CARE on January 24, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GRAND LAKE PRIMARY CARE” is a dba name, the actual legal business name for this organization is RENEE J RUSSELL MD INC. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 10 years ago on Nov 11, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRAND LAKE PRIMARY CARE below.

NPI Profile for
RENEE J RUSSELL MD INC

NPI Number
1316092182
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
RENEE J RUSSELL MD INC
Doing Business As (dba): GRAND LAKE PRIMARY CARE
Primary location
900 E 13TH ST
SUITE 104
GROVE, OK 74344-2975
Phone: (918) 786-3100 Fax: (918) 786-3108
Mailing address
1110 NEO LOOP
GROVE, OK 74344-6046
Phone: (918) 786-3100 Fax: (918) 786-3108
Organization Subpart
No
Authorized Official
RENEE RUSSELL
PROVIDER
Phone: (918) 786-3100
Updated
Identifiers

Identifiers for GRAND LAKE PRIMARY CARE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDOK100017290D
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 OK 22021

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.