Individual provider Active NPI

Kelsey Leigh Brittingham

  • Nurse Practitioner
  • Bartlesville, OK
National Provider Identifier
1003414145
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
123099 Issued in OK
Practice address
3450 E Frank Phillips Blvd Ste 400
Bartlesville, OK 74006-2401
Phone
(918) 338-3740
Fax
(918) 338-3742
NPI assigned
Oct 12, 2020
Last updated
Oct 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 123099 OK
Nurse Practitioner 363L00000X 123099 OK Primary

Addresses

Primary practice location

3450 E Frank Phillips Blvd Ste 400
Bartlesville, OK 74006-2401

Mailing address

3450 E Frank Phillips Blvd Ste 400
Bartlesville, OK 74006-2401
Phone (918) 338-3740

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
I20220201000624 OK Practitioner - Nurse Practitioner 4183017965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123099OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Nov 23, 2021 Accepting new patients
Omni Medical Group Inc CurrentSince Oct 25, 2021 Accepting new patients
St. John Physicians, Inc. CurrentSince Nov 23, 2021 Accepting new patients
Tulsa Pulmonary and Allergy Consultants Inc Past Accepting new patients

Locations

3450 E Frank Phillips Blvd
Ste 400
Bartlesville, OK 74006
Phone (918) 338-3740

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

1725 E 19th St
Ste 200
Tulsa, OK 74104
Phone (918) 748-8381

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1003414145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E FRANK PHILLIPS BLVD STE 400",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062401",
            "telephone_number": "918-338-3740",
            "fax_number": "918-338-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E FRANK PHILLIPS BLVD STE 400",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062401",
            "telephone_number": "918-338-3740",
            "fax_number": "918-338-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTINGHAM",
        "first_name": "KELSEY",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "123099",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "123099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.