Medwise LLC
NPI 1730993460 · Urgent Care Clinic/Center · Broken Arrow, OK
Enrolled with Medicare as Dme Supplier - Other · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1730993460
- Entity type
- Organization
- Primary specialty
- Urgent Care Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Medwise LLC
- Organization subpart
- Yes
- Authorized official
- Dennis Blackstad, President(918) 605-6582
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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)
- Other name
- Medwise LLC - Broken Arrow East
Registry dates
- Enumerated
- 2025-02-04
- Last updated
- 2025-02-04
- Certified
- 2025-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.