Individual provider Active NPI

Kimberly Yvette Hestand, NP-C

  • Nurse Practitioner
  • Hollis, OK
National Provider Identifier
1114391315
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
85865 Issued in OK
Practice address
400 E Sycamore St
Hollis, OK 73550
Phone
(580) 688-2800
Fax
(580) 688-2193
NPI assigned
Nov 25, 2015
Last updated
Mar 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 85865 OK Primary
Family Nurse Practitioner 363LF0000X F1015324 OK

Addresses

Primary practice location

400 E Sycamore St
Hollis, OK 73550

Mailing address

400 E Sycamore St
Hollis, OK 73550-1436
Phone (580) 688-2800

Other practice location 1

100 N 30th St
Clinton, OK 73601-3117
Phone (580) 323-2300

Other practice location 2

400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800

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
I20160125000661 OK Practitioner - Nurse Practitioner 4082917190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 E Sycamore St
Hollis, OK 73550-1436
Phone (580) 688-2800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F1015324OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shortgrass Community Health Center, Inc CurrentSince Mar 1, 2019 Accepting new patients
Shortgrass Community Health Center, Inc CurrentSince Mar 1, 2019 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

101 S Hudson St
Altus, OK 73521
Phone (580) 301-6154

400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800

Interoperability endpoints

  • Direct secure messaging: kimberlyhestand@schc.secure.relimedsolutions.com

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, 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": "1448409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1114391315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SYCAMORE ST",
            "city": "HOLLIS",
            "state": "OK",
            "postal_code": "735501436",
            "telephone_number": "580-688-2800",
            "fax_number": "580-688-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SYCAMORE ST",
            "city": "HOLLIS",
            "state": "OK",
            "postal_code": "73550",
            "telephone_number": "580-688-2800",
            "fax_number": "580-688-2193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N 30th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "OK",
            "postal_code": "736013117",
            "country_code": "US",
            "telephone_number": "580-323-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 E Sycamore St",
            "address_purpose": "LOCATION",
            "city": "Hollis",
            "state": "OK",
            "postal_code": "73550",
            "country_code": "US",
            "telephone_number": "580-688-2800",
            "fax_number": "580-688-2193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HESTAND",
        "first_name": "KIMBERLY",
        "middle_name": "YVETTE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-25",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "85865",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "F1015324",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, OK

Sources for this page

Verify at the official NPI Registry.