Provider Demographics
NPI:1679299457
Name:MERRITTCARE
Entity type:Organization
Organization Name:MERRITTCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TIN OWNER / PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MERRITT-SCHIERMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-513-3037
Mailing Address - Street 1:1515 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-6181
Mailing Address - Country:US
Mailing Address - Phone:405-310-0836
Mailing Address - Fax:405-758-5582
Practice Address - Street 1:2825 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4201
Practice Address - Country:US
Practice Address - Phone:405-610-8056
Practice Address - Fax:405-610-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201118480AMedicaid