Active NPI
Kyle W Rickner, M.D
- Family Medicine Physician
- Edmond, OK
National Provider Identifier
1023020641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21266
- Practice address
- 3808 S. Blvd
Edmond, OK 73013 - Phone
- (405) 471-5655
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21266 | OK | Primary |
Addresses
Primary practice location
3808 S. Blvd
Edmond, OK 73013
Mailing address
3808 S. Blvd
Edmond, OK 73013
Phone (405) 471-5655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100256110A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 17, 2016 through Oct 17, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lightstar Emergency Physicians, PLLC | Past | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Interoperability endpoints
- kyle.rickner@16094314627076.direct.elationemr.com
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
-
- Emergency Medicine Physician
- Shawnee, OK
- NPI 1396736872
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1023020641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3808 S. BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "73013",
"telephone_number": "405-471-5655",
"fax_number": "405-494-7274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3808 S. BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "73013",
"telephone_number": "405-471-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKNER",
"first_name": "KYLE",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "21266",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100256110A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.