Grand Lake Medical and Wellness Corp
NPI 1336706118 · Pain Clinic/Center · Sallisaw, OK
Grand Lake Medical and Wellness Corp is a Pain Clinic/Center organization in Sallisaw, OK (NPI 1336706118).
Provider details
- NPI number
- 1336706118
- Entity type
- Organization
- Primary specialty
- Pain Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Serena Wilson, Owner(918) 961-1658
Specialties & taxonomies
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Serena Wilson
Additional practice locations (1)
- 302 N Greenwood AveFort Smith, AR 72901-3454Phone: (479) 434-3600
Registry dates
- Enumerated
- 2019-05-28
- Last updated
- 2019-05-28
Frequently asked questions
- What is Grand Lake Medical and Wellness Corp's NPI number?
- Grand Lake Medical and Wellness Corp's National Provider Identifier (NPI) is 1336706118, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand Lake Medical and Wellness Corp?
- Grand Lake Medical and Wellness Corp is classified in the NPPES registry as Pain Clinic/Center (Ambulatory Health Care Facilities).
- Where is Grand Lake Medical and Wellness Corp located?
- Grand Lake Medical and Wellness Corp's practice location on file with NPPES is 101 W Quesenbury Ave, Sallisaw, OK 74955-3613.
- What is Grand Lake Medical and Wellness Corp's phone number?
- The practice phone number listed in the NPPES registry for Grand Lake Medical and Wellness Corp is (918) 235-6877.
- Who is the authorized official for Grand Lake Medical and Wellness Corp?
- The authorized official listed on Grand Lake Medical and Wellness Corp's NPPES record is Serena Wilson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand Lake Medical and Wellness Corp's NPI active?
- Yes — Grand Lake Medical and Wellness Corp's NPI (1336706118) is active in the NPPES registry as of the last update on 2019-05-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.