Individual provider Active NPI

Anecia Michel Pearson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1063084044
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
217608 Issued in OK
Practice address
755 W Covell Rd Ste 100
Edmond, OK 73003-2381
Phone
(405) 378-2727
NPI assigned
Jul 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11011568 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 217608 OK Primary

Addresses

Primary practice location

755 W Covell Rd Ste 100
Edmond, OK 73003-2381

Mailing address

755 W Covell Rd Ste 100
Edmond, OK 73003-2381
Phone (405) 378-2727

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL anecia.pearson@va.gov

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1105 SW 30TH CT
Moore, OK 73160-2887

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11011568FLMDPsychiatric/Mental Health Nurse Practitioner
217608OKMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1063084044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 W COVELL RD STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730032381",
            "telephone_number": "405-378-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 W COVELL RD STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730032381",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "ANECIA",
        "middle_name": "MICHEL",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11011568",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "217608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "anecia.pearson@va.gov",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "10000 Bay Pines Blvd",
            "city": "Bay Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337448200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.