Individual provider Active NPI

Casie Nicole Brim, NP

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1003196684
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
80718 Issued in OK
Practice address
1919 S Wheeling Ave
Suite 606
Tulsa, OK 74104-5638
Phone
(918) 748-7676
Fax
(918) 293-3130
NPI assigned
Aug 26, 2011
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 80718 OK Primary

Addresses

Primary practice location

1919 S Wheeling Ave
Suite 606
Tulsa, OK 74104-5638

Mailing address

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104-5635
Phone (918) 748-7676

Other names 1

  • Casie Nicole Benton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111207000846 OK Practitioner - Nurse Practitioner 1850566548 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
80718OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Sep 5, 2011 Accepting new patients
St. John Physicians, Inc. CurrentSince Sep 5, 2011 Accepting new patients

Locations

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1919 S Wheeling Ave
Ste 606
Tulsa, OK 74104
Phone (918) 748-7676

Interoperability endpoints

  • Direct secure messaging: casie.brim@direct.stjohnhealthsystem.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1003196684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "STE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045635",
            "telephone_number": "918-748-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S WHEELING AVE",
            "address_2": "SUITE 606",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045638",
            "telephone_number": "918-748-7676",
            "fax_number": "918-293-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIM",
        "first_name": "CASIE",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "80718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASIE",
            "last_name": "BENTON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.