Individual provider Active NPI

Cynthia D Noble, FNP

  • Family Nurse Practitioner
  • Fairland, OK
National Provider Identifier
1114074291
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71128 Issued in OK
Practice address
209 W Conner, Suite a
Fairland, OK 74343
Phone
(918) 848-5028
NPI assigned
Jan 4, 2007
Last updated
Mar 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AO3191APN AR
Family Nurse Practitioner 363LF0000X 71128 OK Primary

Addresses

Primary practice location

209 W Conner, Suite a
Fairland, OK 74343

Mailing address

PO Box 570
Fairland, OK 74343-0570
Phone (918) 848-5028

Other identifiers 1

IdentifierTypeStateIssuer
200187150AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.quickcarefamilymedicine.com Direct

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
I20150130001011 OK Practitioner - Nurse Practitioner 4082752159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychcare of Oklahoma, LLCGroup PAC ID 9638566839, 5 clinicians

Practice addresses (Care Compare)

209 W Conner Ave
Suite a
Fairland, OK 74343-4713
Phone (918) 848-5028

8555 S Lewis Ave
Tulsa, OK 74137-1218
Phone (713) 850-0049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO3191APNARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quickcare Family Medicine LLC Family CurrentSince Feb 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1114074291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570",
            "city": "FAIRLAND",
            "state": "OK",
            "postal_code": "743430570",
            "telephone_number": "918-848-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W CONNER, SUITE A",
            "city": "FAIRLAND",
            "state": "OK",
            "postal_code": "74343",
            "telephone_number": "918-848-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "CYNTHIA",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-03-21",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "AO3191APN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "71128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200187150A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.quickcarefamilymedicine.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "209 W Conner, Suite A",
            "city": "Fairland",
            "state": "OK",
            "country_code": "US",
            "postal_code": "74343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairland, OK

Sources for this page

Verify at the official NPI Registry.