=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720930688
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTERN PLAINS FAMILY MEDICINE, LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90 N 30TH ST STE 1
-----------------------------------------------------
City | CLINTON
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73601-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-323-0232
-----------------------------------------------------
Fax | 580-942-2256
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 N 30TH ST STE 1
-----------------------------------------------------
City | CLINTON
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73601-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-323-0232
-----------------------------------------------------
Fax | 580-942-2256
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | JESSICA SIMMONS
-----------------------------------------------------
Credential | APRN, FNP-BC
-----------------------------------------------------
Telephone | 580-323-0232
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------