Individual provider Active NPI

Ebonie Chanell Pankey, APRN, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1093220402
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R0083510 Issued in OK
Practice address
4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Phone
(405) 378-2727
Fax
(405) 378-2776
NPI assigned
Dec 7, 2017
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135996 TX
Family Nurse Practitioner 363LF0000X 251622 GA
Family Nurse Practitioner 363LF0000X R0083510 OK
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R0083510 OK Primary
Registered Nurse 163W00000X R0083510 OK

Addresses

Primary practice location

4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618

Mailing address

4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Phone (405) 378-2727

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
I20180830002604 OK Practitioner - Nurse Practitioner 5698025369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balance Womens Health LLCGroup PAC ID 3476927740, 89 clinicians

Practice addresses (Care Compare)

4013 NW Expressway
Suite 105
Oklahoma City, OK 73116-2618
Phone (405) 378-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251622GAMDFamily Nurse Practitioner
R0083510OKMDFamily Nurse Practitioner
AP135996TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shortgrass Community Health Center, Inc Current Accepting new patients
Spectrum Healthcare Solutions, PLLC CurrentSince May 30, 2018 Accepting new patients
Balance Women's Health, LLC CurrentSince Feb 7, 2024 Accepting new patients

Locations

1105 SW 30th Ct
Moore, OK 73160
Phone (405) 676-5114

4013 NW Expressway
Ste 105
Oklahoma City, OK 73116
Phone (405) 676-8470

4220 N Classen Blvd
Ste A
Oklahoma City, OK 73118
Phone (405) 768-5749

Interoperability endpoints

  • Direct secure messaging: eboniepankey@schc.secure.relimedsolutions.com
  • Direct secure messaging: lifestancehealth.eboniepankey@148561.advancedmd-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1093220402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727",
            "fax_number": "405-378-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727",
            "fax_number": "405-378-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKEY",
        "first_name": "EBONIE",
        "middle_name": "CHANELL",
        "credential": "APRN, PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135996",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "251622",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0083510",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "R0083510",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0083510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.