Individual provider Active NPI

Kelli M Bryan, APRN

  • Family Nurse Practitioner
  • Norman, OK
National Provider Identifier
1114178134
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10251 Issued in OH
Practice address
3261 24TH Ave NW Ste 101
Norman, OK 73069
Phone
(405) 364-6432
Fax
(937) 438-1291
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 10251 OH Primary

Addresses

Primary practice location

3261 24TH Ave NW Ste 101
Norman, OK 73069

Mailing address

3261 24TH Ave NW Ste 101
Norman, OK 73069
Phone (937) 297-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10251OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Regional Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Premiere Pediatrics PLLC Past Accepting new patients

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1114178134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 24TH AVE NW STE 101",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73069",
            "telephone_number": "937-297-8999",
            "fax_number": "937-299-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 24TH AVE NW STE 101",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73069",
            "telephone_number": "405-364-6432",
            "fax_number": "937-438-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KELLI",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "10251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.