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Active NPI 1245430073 Organization (Entity Type 2)

Dynamicare

Home Health • Broken Arrow, OK

About Dynamicare NPI 1245430073 Summary

Dynamicare is a verified healthcare organization specializing in Home Health operating in Broken Arrow, OK. Located at 1409 E RENO ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1245430073.

Administrative operations and authorized compliance are overseen by Michael Mccarthy (Ceo).

Facility Location & Contact Primary Location

Facility Address

1409 E Reno St

Broken Arrow, OK 740129380

Telephone 9187203442
Fax 9183551330

Authorized Official Information

Authorized Contact Name

Michael Mccarthy , LPTA

Title / Role

Ceo

Official Telephone

9187203442

Facility Classifications & Specialties

Home Health Primary Taxonomy

NUCC Taxonomy Code: 251E00000X

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active July 19, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 19, 2007

Registered at 1409 E RENO ST, BROKEN ARROW, OK 740129380 (Tel: 9187203442)

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Updated Business Mailing Address July 19, 2007

Registered at 1409 E RENO ST, BROKEN ARROW, OK 740129380 (Tel: 9187203442)

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Organization / Clinic Name Updated July 19, 2007

Operating as DYNAMICARE

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2007

Home Health (License #TA748 in OK)

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Initial NPI Registration & Enumeration July 19, 2007

First registered as active Healthcare Organization in NPPES Database.

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NPI Organization Metadata

NPI Number: 1245430073
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 19, 2007
Last Update: July 19, 2007

Mailing Address

1409 E Reno St

Broken Arrow, OK 740129380

Phone: 9187203442

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.