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Canyon Park Medical Group, Pllc

Primary Care Clinic/Center in Edmond, OK · enumerated 2006 · authorized official Tonya Keith, Clinic Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063525954

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Registry record

Entity type Organization (Type 2)
Legal business name Canyon Park Medical Group, Pllc
Practice address 1501 E 19th St, Edmond, OK, 73013
Phone (405) 348-6611
Fax (405) 348-9280
Enumeration date Aug 16, 2006
Last updated in NPPES May 2, 2011

Taxonomy & classification

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities · License 8699 (OK) Primary

Authorized official

Name Tonya Keith
Title Clinic Manager
Phone (405) 348-6611

Other identifiers

Identifier Type State Issuer
37DO469469 Other OK CLIA #
CH5055 Other OK RAILROAD MEDICARE #
100748060A Medicaid OK -
4589400001 Other OK DMERC GROUP #

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Canyon Park Medical Group, Pllc?
The NPI for Canyon Park Medical Group, Pllc is 1063525954, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Canyon Park Medical Group, Pllc?
NPPES lists Tonya Keith (Clinic Manager) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-05-02.