NPIMap

Individual provider Active NPI

Bettina Veronneau, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1083663322
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17563 Issued in OK
Practice address
1575 N Santa Fe Ave
Edmond, OK 73003-3638
Phone
(405) 285-0660
Fax
(405) 285-0659
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17563 OK Primary

Addresses

Primary practice location

1575 N Santa Fe Ave
Edmond, OK 73003-3638

Mailing address

4401 W Memorial Rd
Suite 140
Oklahoma City, OK 73134-1785
Phone (405) 752-3162

Other identifiers 3

IdentifierTypeStateIssuer
200059560AMedicaidOK
22871OtherOKOBNDD
17563OtherOKLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000221 OK Practitioner - Family Practice 5991749756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1575 N Santa Fe Ave
Edmond, OK 73003-3638
Phone (405) 285-0660

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17563OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Family Medicine CurrentSince Jan 1, 2011 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1575 N Santa Fe Ave
Edmond, OK 73003
Phone (405) 285-0600

820 W 15th St
Edmond, OK 73013
Phone (405) 348-1207

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

Interoperability endpoints

  • Direct secure messaging: bveronneau17254@directc.mercy.net

Organizations & group practices 6

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1083663322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-752-3162",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N SANTA FE AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033638",
            "telephone_number": "405-285-0660",
            "fax_number": "405-285-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERONNEAU",
        "first_name": "BETTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "17563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200059560A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBNDD",
            "identifier": "22871",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "17563",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.