OrganizationActive
Phoenix Primary Care, LLC
NPI 1952890337 · Primary Care Clinic/Center · Pawnee, OK
Provider details
- NPI number
- 1952890337
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Niko Koliastasis, Ceo(918) 636-3930
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs 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
557 Harrison St
Pawnee, OK 74058-2566
Phone: (918) 762-5050
Fax: (877) 515-8550
Street-level locationGet directions
Mailing address
209 N Oak St
Sallisaw, OK 74955-4639
Registry dates
- Enumerated
- 2018-05-01
- Last updated
- 2020-01-08
- Certified
- 2020-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.