Destiny Ruosa Mitchell, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

79374 Issued in OK

Practice address

781 Grand Casino Blvd
Shawnee, OK 74804-1005

Phone

(405) 964-5770

Fax

(405) 964-5788

NPI assigned

Jun 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

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.

• Citizen Potawatomi Nation

  • Federally Qualified Health Center (FQHC)
  • Shawnee, OK
  • NPI 1881981744

  TX

  Medicare reassignment Care Compare group NPD
• Citizen Potawatomi Nation

  • Federally Qualified Health Center (FQHC)
  • Shawnee, OK
  • NPI 1194752949
  NPD
• Citizen Potawatomi Nation

  • Chiropractor
  • Shawnee, OK
  • NPI 1427659523
  NPD

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1114309317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 GRAND CASINO BLVD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041005",
            "telephone_number": "405-964-5770",
            "fax_number": "405-964-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 GRAND CASINO BLVD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041005",
            "telephone_number": "405-964-5770",
            "fax_number": "405-964-5788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2307 Gordon Cooper Dr",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748019007",
            "country_code": "US",
            "telephone_number": "405-273-5236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "DESTINY",
        "middle_name": "RUOSA",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "79374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylee Ann Mills, PBT
• Steven Wayne Mills, LCSW
• Sheldon Milton, BHCM2
• Christopher Andrew Minnigh, DDS
• Hannah Mire, LMFT
• Keeley D Mitchell, M. ED.
• Terri Lea Mitchell, LPC
• Tandi Jean Mize, LCSW
• Laura Elizabeth Monroe, CPRSS
• Dylan Montgomery

• Family Nurse Practitioner in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.