Individual provider Active NPI

Charlene D Hoover, ARNP

  • Family Nurse Practitioner
  • Catoosa, OK
National Provider Identifier
1104092964
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0074731 Issued in OK
Practice address
5232 N Highway 167
Catoosa, OK 74015-3434
Phone
(918) 272-0033
Fax
(918) 272-0039
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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 R0074731 OK Primary

Addresses

Primary practice location

5232 N Highway 167
Catoosa, OK 74015-3434

Mailing address

5232 N Highway 167
Catoosa, OK 74015-3434
Phone (918) 272-0033

Other identifiers 1

IdentifierTypeStateIssuer
200416390BMedicaidOK

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
I20111115000397 OK Practitioner - Nurse Practitioner 0648444356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prophylaxis Healthcare LLCGroup PAC ID 3072784289, 26 clinicians
Essentialmd, PLLCGroup PAC ID 0941620637, 3 clinicians

Practice addresses (Care Compare)

303 E Taft Ave
3 Axis Healthcare Sapulpa
Sapulpa, OK 74066-5651
Phone (918) 224-2222

6316 E 102ND St
Suite 100
Tulsa, OK 74137-7061
Phone (918) 600-2233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0074731OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Essentialmd, PLLC CurrentSince Dec 4, 2023 Accepting new patients
Oklahoma Pain and Wellness Center, PLC PastSince Jan 14, 2018 Accepting new patients
Ntco LLC Past Accepting new patients
Ahs Oklahoma Physician Group LLC PastSince Aug 1, 2018 Accepting new patients
Feet Plus Solutions Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22562/brand/1/csg/1/fhir/r4
  • Direct secure messaging: charlene.hoover.1@22562.direct.athenahealth.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1104092964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5232 N HIGHWAY 167",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740153434",
            "telephone_number": "918-272-0033",
            "fax_number": "918-272-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 N HIGHWAY 167",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740153434",
            "telephone_number": "918-272-0033",
            "fax_number": "918-272-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "CHARLENE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0074731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200416390B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catoosa, OK

Sources for this page

Verify at the official NPI Registry.