Individual provider Active NPI

Nydia E Parks, APRN

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1104240183
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
104820 Issued in OK
Practice address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone
(918) 579-3871
Fax
(918) 579-3809
NPI assigned
Feb 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 104820 OK Primary

Addresses

Primary practice location

1120 S Utica Ave
Tulsa, OK 74104-4012

Mailing address

1145 S Utica Ave
Suite 110
Tulsa, OK 74104-4013
Phone (918) 579-3826

Other practice location 1

2130 SW 59th St
Oklahoma City, OK 73119-7025
Phone (403) 303-7555

Other practice location 2

11511 E 31st St
Tulsa, OK 74146-1908
Phone (918) 400-7002

Other practice location 3

198 NE 23rd St
Oklahoma City, OK 73111-3328
Phone (405) 453-8000

Other practice location 4

7521 SE 15th St
Midwest City, OK 73110-5425
Phone (405) 453-8004

Other practice location 5

1538 N Lewis Ave
Tulsa, OK 74110-2535
Phone (918) 400-7001

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
I20140428001004 OK Practitioner - Nurse Practitioner 0345473336 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104820OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Choice Medical Services CurrentSince Sep 22, 2025 Accepting new patients
Novastar Family Medicine LLC CurrentSince Sep 22, 2025 Accepting new patients
Oak Street Health of Georgia PC Nurse Practitioner PastSince Jan 22, 2024 Accepting new patients

Locations

5350 E 46th St
Ste 100
Tulsa, OK 74135
Phone (918) 660-6886

5046 N Peoria Ave
Ste 300
Tulsa, OK 74126
Phone (601) 597-4840

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/23354/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1104240183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3826",
            "fax_number": "918-579-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044012",
            "telephone_number": "918-579-3871",
            "fax_number": "918-579-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 SW 59th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731197025",
            "country_code": "US",
            "telephone_number": "403-303-7555",
            "fax_number": "405-561-5615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11511 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741461908",
            "country_code": "US",
            "telephone_number": "918-400-7002",
            "fax_number": "539-202-5130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "198 NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113328",
            "country_code": "US",
            "telephone_number": "405-453-8000",
            "fax_number": "405-561-4984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7521 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731105425",
            "country_code": "US",
            "telephone_number": "405-453-8004",
            "fax_number": "405-561-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1538 N Lewis Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741102535",
            "country_code": "US",
            "telephone_number": "918-400-7001",
            "fax_number": "539-202-5070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKS",
        "first_name": "NYDIA",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "104820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.