Tina Diane Gerwin, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

216494 Issued in OK

Practice address

1570 Provence Rd
Ardmore, OK 73401-0401

Phone

(580) 220-4427

NPI assigned

Feb 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tina Diane Dorris Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951

  OK

  Medicare reassignment NPD

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1033975784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 PROVENCE RD",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734010401",
            "telephone_number": "580-220-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 PROVENCE RD",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734010401",
            "telephone_number": "580-220-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERWIN",
        "first_name": "TINA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "216494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "DORRIS",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Gentis
• Gerald Vincy Cross, D.D.S., Mba, Inc.
• Geriatric Center of Southern Ok
• Gerken Orthodontics, LLC
• Craig A Gerken, DDS
• Gibson Counseling Services, Inc, PC
• Ryan Gibson
• Felicia Giddings Jefferson
• Jeri Ann Gill, PHYSICAL THERAPIST
• Bruce Stewart Gilmore, M.D.

• Family Nurse Practitioner in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.