Healthcare Provider Details

I. General information

NPI: 1891683488
Provider Name (Legal Business Name): VALLEY HOPE MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S JONES AVE
CUSHING OK
74023-4900
US

IV. Provider business mailing address

PO BOX 800081
KANSAS CITY MO
64180-0081
US

V. Phone/Fax

Practice location:
  • Phone: 918-225-1736
  • Fax: 918-225-7742
Mailing address:
  • Phone: 785-877-5169
  • Fax: 785-877-4104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHY ERBERT
Title or Position: DIR OF CONTRACT ADMIN
Credential:
Phone: 785-877-5111