MEDICARE: SAGE PRIMARY HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1033798277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGE PRIMARY HEALTH PLLC

Provider Business Mailing Address
First Line	:	PO BOX 156
Second Line	:
City	:	HARRAH
State	:	OK
Zip	:	73045-0156
Country	:	US
Telephone Number	:	405-347-9017
Fax Number	:	833-907-2166

Provider Business Practice Location Address
First Line	:	20213 NE 23RD ST STE B1
Second Line	:
City	:	HARRAH
State	:	OK
Zip	:	73045-9144
Country	:	US
Telephone Number	:	405-590-2032
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	JENNIFER MCCAMMOND
Credential	:	APRN-CNP
Telephone Number	:	405-347-9017

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	05/12/2026

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Directions to “SAGE PRIMARY HEALTH PLLC ” Practice Location

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