NPIMap

Individual provider Active NPI

Theleka Williams, APRN-CNP

  • Family Nurse Practitioner
  • Lawton, OK
National Provider Identifier
1063882140
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
96370 Issued in OK
Practice address
6744 NW Cache Rd
Lawton, OK 73505-2702
Phone
(580) 536-9355
Fax
(580) 536-3537
NPI assigned
Oct 1, 2015
Last updated
Feb 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 96370 OK Primary

Addresses

Primary practice location

6744 NW Cache Rd
Lawton, OK 73505-2702

Mailing address

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200406001489 OK Practitioner - Nurse Practitioner 7517396963 Reassigns benefits to 7 organizations
I20251111002265 TX Practitioner - Nurse Practitioner 7517396963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

3209 S Broadway
Suite 229
Edmond, OK 73013-4064
Phone (551) 295-8223

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96370OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC NJ III PC CurrentSince Mar 9, 2026 Accepting new patients
Tulsa Emergency Medical Center Inc CurrentSince Dec 1, 2024 Accepting new patients
Medical Resource Management, LLC CurrentSince Dec 1, 2024 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Mar 11, 2020 Accepting new patients
Ennoble HC NJ PC CurrentSince Mar 9, 2026 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Mar 11, 2020 Accepting new patients
Signify Health, LLC CurrentSince Oct 1, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Oct 1, 2025 Accepting new patients
Ennoble HC NJ II PC CurrentSince Mar 9, 2026 Accepting new patients
Williams Medical Group Practice, LLC PastSince Oct 21, 2025 Accepting new patients

Locations

416 N Main St
Altus, OK 73521
Phone (580) 379-0325

3209 S Broadway
Ste 229
Edmond, OK 73013
Phone 5512958223 ext. 58223

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

6744 NW Cache Rd
Lawton, OK 73505
Phone (580) 536-9355

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1063882140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6744 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735052702",
            "telephone_number": "580-536-9355",
            "fax_number": "580-536-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "THELEKA",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "96370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.