Individual provider Active NPI

Fallon Thompson

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1104578418
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
215536 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 502-1900
Fax
(918) 494-6303
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 215536 OK Primary
Registered Nurse 163W00000X R0136311 OK

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

211 E Juneau PL
Broken Arrow, OK 74012-8269
Phone (918) 289-3697

Other practice location 1

1819 E 19th St Ste 500
Tulsa, OK 74104-5429
Phone (918) 744-3600

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
I20240221000622 OK Practitioner - Nurse Practitioner 9537503263 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0136311OKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Apr 1, 2024 Accepting new patients
Warren Clinic Inc CurrentSince Jul 7, 2025 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
St. John Physicians, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Tulsa Cancer Institute PLLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC CurrentSince Jan 22, 2024 Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Jan 22, 2024 Accepting new patients
Care Communications LLC CurrentSince Jul 7, 2025 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Past Accepting new patients
St John Medical Center Inc Past Accepting new patients

Locations

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1819 E 19th St
Fl 5
Tulsa, OK 74104
Phone (918) 505-3200

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6161 S Yale Ave
#A
Tulsa, OK 74136

6600 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-1805

1819 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 744-3600

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: fthompson37958@direct.saintfrancis.com

Organizations & group practices 10

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1104578418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E JUNEAU PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128269",
            "telephone_number": "918-289-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-502-1900",
            "fax_number": "918-494-6303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 E 19th St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045429",
            "country_code": "US",
            "telephone_number": "918-744-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "FALLON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "215536",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0136311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.