Variety Care Fort Cobb – Federally Qualified Health Center (FQHC), NPI 1275646143

Variety Care Fort Cobb is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Variety Care Fort Cobb is 1275646143

Main info

Organization
Name
Variety Care Fort Cobb
NPI
1275646143
Phone
(405) 632-6688
Address
3000 N GRAND BLVD
Authorized Official
TIM REDDOUT CFO
Enumeration Date
16 August 2006
Last Update Date
26 February 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Variety Care Fort Cobb

  • 3000, Northwest Grand Boulevard, Oklahoma City, Oklahoma County, Oklahoma, 73107, United States

    OKLAHOMA CITY, OK 731071818

    Phone: (405) 632-6688

    Fax: (844) 689-9671

    Type: Mailing

  • Main Street, Fort Cobb, Caddo County, Oklahoma, 73038, United States

    FORT COBB, OK 730385866

    Phone: (405) 632-6688

    Fax: (405) 643-9296

    Type: Location

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-12-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-12-31 (162 days ago).

Enrollment records

2

Earliest due date

2025-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040105000467OClinic/Group PracticeOK2025-12-31
O20041221000840OFederally Qualified Health Center (Fqhc)OKTBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 73107)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Variety Care Fort Cobb?
Variety Care Fort Cobb — NPI 1275646143 — is the standard way to identify this listing.
Is Variety Care Fort Cobb listed as active for patients and plans?
The listing shows Variety Care Fort Cobb as active in the NPI system.
What is Variety Care Fort Cobb's primary classification?
Federally Qualified Health Center (FQHC) is the headline specialty for Variety Care Fort Cobb here. Clinical services aligned with this taxonomy classification.
Where is Variety Care Fort Cobb based?
Variety Care Fort Cobb is tied to Oklahoma City, Oklahoma in the data we show; additional addresses may exist on the full record.
Why does Variety Care Fort Cobb have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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