Individual provider Active NPI

Kyndal Renee' Stevens, APRN-CNP

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1083250757
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
97099 Issued in OK
Practice address
2617 S Elm PL
Broken Arrow, OK 74012-7850
Phone
(918) 455-0414
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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 97099 OK Primary

Addresses

Primary practice location

2617 S Elm PL
Broken Arrow, OK 74012-7850

Mailing address

1409 W 118TH St S
Jenks, OK 74037-4262
Phone (405) 642-2308

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kyndal.stevens@hillcrest.com Direct

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
I20191216000162 OK Practitioner - Nurse Practitioner 1759714231 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
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

2617 S Elm PL
Suite 100
Broken Arrow, OK 74012-7850
Phone (918) 455-4541

Hospital & facility affiliations

  • Elara Caring XXV Home health agency, Tulsa, OK, CCN 377667
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group, LLC CurrentSince Dec 23, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Dec 23, 2019 Accepting new patients

Locations

2617 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 455-4541

2617 S Elm Pl
Ste 100
Broken Arrow, OK 74012
Phone (918) 455-4541

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

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

Interoperability endpoints

  • Direct secure messaging: kstevens109857@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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 5

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1083250757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W 118TH ST S",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740374262",
            "telephone_number": "405-642-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 S ELM PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127850",
            "telephone_number": "918-455-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KYNDAL",
        "middle_name": "RENEE'",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "97099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyndal.stevens@hillcrest.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2617 S Elm Pl",
            "city": "Broken Arrow",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740127850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.