CANYON PARK MEDICAL GROUP, PLLC – Primary Care Clinic/Center, NPI 1063525954

CANYON PARK MEDICAL GROUP, PLLC is a healthcare provider. based in Edmond, Oklahoma. specializing in Primary Care Clinic/Center. The organization holds a License No. 8699 (OK). The NPI Number for CANYON PARK MEDICAL GROUP, PLLC is 1063525954

Main info

Organization
Name
CANYON PARK MEDICAL GROUP, PLLC
NPI
1063525954
Phone
(405) 348-6611
Address
1501 E 19TH ST
Authorized Official
TONYA LYNN KEITH CLINIC MANAGER
Enumeration Date
16 August 2006
Last Update Date
2 May 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for CANYON PARK MEDICAL GROUP, PLLC

  • 1501, East 19th Street, Canyon Park, Edmond, Oklahoma County, Oklahoma, 73013, United States

    EDMOND, OK 730136618

    Phone: (405) 348-6611

    Fax: (405) 348-9280

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73013)

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Frequently asked questions

Where can patients find CANYON PARK MEDICAL GROUP, PLLC's NPI?
You can confirm CANYON PARK MEDICAL GROUP, PLLC with NPI 1063525954; it appears in the national provider directory.
Is CANYON PARK MEDICAL GROUP, PLLC currently active in the NPI registry?
CMS-published data lists CANYON PARK MEDICAL GROUP, PLLC as an active registrant.
What kind of provider is CANYON PARK MEDICAL GROUP, PLLC?
The page reflects Primary Care Clinic/Center for CANYON PARK MEDICAL GROUP, PLLC. Clinical services aligned with this taxonomy classification.
Does CANYON PARK MEDICAL GROUP, PLLC practice in Oklahoma?
You will see Edmond, Oklahoma on file for CANYON PARK MEDICAL GROUP, PLLC alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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