Individual provider Active NPI

Courtney Roberts, APRN-FNP

  • Family Nurse Practitioner
  • Muskogee, OK
National Provider Identifier
1003643859
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219622 Issued in OK
Practice address
615 S 32ND St
Muskogee, OK 74401-5012
Phone
(539) 239-5240
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 219622 OK Primary

Addresses

Primary practice location

615 S 32ND St
Muskogee, OK 74401-5012

Mailing address

609 Country LN
Salina, OK 74365-3220

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
I20250715001057 OK Practitioner - Nurse Practitioner 5890200265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

615 S 32ND St
Muskogee, OK 74401-5012
Phone (593) 239-5240

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Jul 1, 2025 Accepting new patients
Vialife Hospice LLC PastSince Jun 15, 2025 Accepting new patients
Vialife Corporation PastSince Sep 1, 2024 Accepting new patients

Locations

615 S 32nd St
Muskogee, OK 74401
Phone (539) 239-5240

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

Dept 1206
Tulsa, OK 74182

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

Interoperability endpoints

  • Direct secure messaging: croberts1335939@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1003643859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 COUNTRY LN",
            "city": "SALINA",
            "state": "OK",
            "postal_code": "743653220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S 32ND ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015012",
            "telephone_number": "539-239-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "COURTNEY",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "219622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.