Individual provider Active NPI

Connie Lynn Whitaker, APRN, FNP-C

  • Family Nurse Practitioner
  • Norman, OK
National Provider Identifier
1083238612
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
92179 Issued in OK
Practice address
808 Wall St
Norman, OK 73069-6302
Phone
(405) 997-4321
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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 92179 OK Primary

Addresses

Primary practice location

808 Wall St
Norman, OK 73069-6302

Mailing address

808 Wall St
Norman, OK 73069-6302
Phone (405) 977-4321

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
I20200624003418 OK Practitioner - Nurse Practitioner 1951723675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma Arthritis Center, P.C.Group PAC ID 0446239743, 45 clinicians

Practice addresses (Care Compare)

808 Wall St
Norman, OK 73069-6302
Phone (405) 844-4978

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.12 of 100Reported as group
Quality
64.14
Promoting interoperability
75
Improvement activities
40
Cost
70.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92179OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Arthritis Center, P.C. CurrentSince Aug 15, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1701 Renaissance Blvd
Ste 110
Edmond, OK 73013
Phone (405) 844-4978

1705 Renaissance Blvd
Ste 120
Edmond, OK 73013
Phone (405) 715-4496

808 Wall St
Norman, OK 73069
Phone (405) 321-5114

Interoperability endpoints

  • Direct secure messaging: conniewhitaker@oac.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1083238612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 WALL ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696302",
            "telephone_number": "405-977-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 WALL ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696302",
            "telephone_number": "405-997-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "92179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.