Kristine Elaine Bryant, D.O.
Individual provider Active NPI Obstetrics & Gynecology Physician · Jenks, OK
NPI 1043553902 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1043553902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 5529 (OK)
- Practice address
- 701 E Main St
Jenks, OK 74037-4316 - Phone
- (918) 298-2264
- Fax
- (918) 298-0923
- NPI assigned
- Mar 28, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Oklahoma State University College of Osteopathic Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ahs Oklahoma Physician Group LLC
Practice addresses (Care Compare)
701 E Main St
Jenks, OK 74037-4316
Phone (918) 298-2264
Hospital & facility affiliations
- Hillcrest Hospital South
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170810000784 | OK | Practitioner - Obstetrics/Gynecology | 1254602170 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5529 | OK | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Oklahoma Physician Group, LLC | Current |
Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Current |
Accepting new patients | |
| Ahs Southcrest Hospital, LLC | Past | Accepting new patients |
Locations
701 E Main St
Jenks, OK 74037
Phone (918) 298-2264
20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675
Dept 1206
Tulsa, OK 74182
Interoperability endpoints
- kbryant113453@ahs.direct-ci.com
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 5529 | OK | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
701 E Main St
Jenks, OK 74037-4316
Mailing address
701 E Main St
Jenks, OK 74037-4316
Phone (918) 298-2264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200548260 | Medicaid | OK |
Other names
- Kristine Elaine Johnson
Other providers in Jenks, OK
- Melissa Ann Broaddus
- Brookshire Grocery Company
- Amy Marie Brown
- Mackenzie Brubaker
- Jaselyn Mackenzee Bruce
- Matthew Buhr
- Mia Burge
- Chloe Renee Burgess
- Joshua Burke
- Joel Nicholas Burks
All providers in Jenks, OK · Obstetrics & Gynecology Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.