Individual provider Active NPI

Suzanne Kirby

  • Acute Care Clinical Nurse Specialist
  • Tulsa, OK
National Provider Identifier
1023415841
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
83127 Issued in OK
Practice address
1145 S Utica Ave Ste 1105
Tulsa, OK 74104
Phone
(918) 579-5749
NPI assigned
Nov 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 83127 OK Primary

Addresses

Primary practice location

1145 S Utica Ave Ste 1105
Tulsa, OK 74104

Mailing address

3450 E Frank Phillips Blvd
Ste 200
Bartlesville, OK 74006-2401
Phone (918) 331-2445

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
I20141217000495 OK Practitioner - Certified Clinical Nurse Specialist (CNS) 2860715240 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
83127OKMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jun 24, 2019 Accepting new patients
St. John Physicians, Inc. CurrentSince Jun 24, 2019 Accepting new patients

Locations

3450 E Frank Phillips Blvd
Ste 200
Bartlesville, OK 74006
Phone (918) 331-2444

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

1145 S Utica Ave
Ste 460
Tulsa, OK 74104
Phone (918) 392-8884

1145 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-2368

1145 S Utica Ave
Ste 1105
Tulsa, OK 74104
Phone (918) 579-5724

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1023415841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E FRANK PHILLIPS BLVD",
            "address_2": "STE 200",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062401",
            "telephone_number": "918-331-2445",
            "fax_number": "918-331-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE STE 1105",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-579-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "OK",
            "license": "83127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.