Vanessa Dicus, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0122192 Issued in OK

Practice address

20567 E Kambrie Rd
Inola, OK 74036-5334

Phone

(405) 659-6711

NPI assigned

May 12, 2021

Sex

Female

Sole proprietor

Yes

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

• Northeastern Health System

  • Emergency Medicine Physician
  • Tahlequah, OK
  • NPI 1457574170

  OK, Single Specialty

  Medicare reassignment NPD
• Northeastern Health System

  • Rural Health Clinic/Center
  • Tahlequah, OK
  • NPI 1306387949
  NPD
• Northeastern Health System

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1003865999
  NPD (past)
• Northeastern Health System

  • Psychiatric Hospital Unit
  • Tahlequah, OK
  • NPI 1619031465
  NPD (past)
• Tahlequah Medical Group LLC

  • Family Medicine Physician
  • Tahlequah, OK
  • NPI 1881960771

  Single Specialty

  NPD (past)

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 12, 2022.

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1003480237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20672 E KAMBRIE RD",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365349",
            "telephone_number": "405-659-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20567 E KAMBRIE RD",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365334",
            "telephone_number": "405-659-6711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5210 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729047362",
            "country_code": "US",
            "telephone_number": "479-788-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICUS",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0122192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vdicus@mppinfusion.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "209 S 36th St",
            "city": "Muskogee",
            "state": "OK",
            "country_code": "US",
            "postal_code": "744015043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Batalo
• Kaylee Broce
• Carla J. Bynum, D.PH.
• Careatc
• Jason E Cook, D.C.
• Stephanie Hurd
• Inola Drug Inc
• Inola Drug, Inc
• Inola Health Care Center, Inc
• Inola Public Schools

• All providers in Inola, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.