# FEDCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083585491
- **Authorized official:** EMILI GRAGG (OPERATIONS MANAGER)
- **Authorized official phone:** (405) 219-2651

## Contact information

- **Practice address:** 1801 N BROADWAY AVE, OKLAHOMA CITY, OK 73103-3446
- **Practice address phone:** (405) 219-2651
- **Practice address fax:** (405) 429-5191
- **Mailing address:** PO BOX 152, OKLAHOMA CITY, OK 73101-0152
- **Mailing address phone:** (405) 219-2651
- **Mailing address fax:** (405) 609-6679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 209800000X | Legal Medicine (M.D./D.O.) Physician | — | NULL | — |
| 209800000X | Legal Medicine (M.D./D.O.) Physician | — | — | — |

## Other

- **Enumeration date:** 09/17/2025
- **Last updated:** 09/17/2025