Individual provider Active NPI

Jennifer Pettit, APRN

  • Acute Care Nurse Practitioner
  • Sallisaw, OK
National Provider Identifier
1114599081
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
203920 Issued in OK
Practice address
301 S J T Stites St
Sallisaw, OK 74955-9302
Phone
(918) 774-1400
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 203920 OK Primary

Addresses

Primary practice location

301 S J T Stites St
Sallisaw, OK 74955-9302

Mailing address

301 S J T Stites St
Sallisaw, OK 74955-9302
Phone (918) 774-1400

Other practice location 1

103 W Choctaw Ave
Sallisaw, OK 74955-4416
Phone (918) 271-6058

Other identifiers 2

IdentifierTypeStateIssuer
288261758MedicaidOK
288261758MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230502000098 TX Practitioner - Nurse Practitioner 9537524368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

301 S J T Stites St
Sallisaw, OK 74955-9302
Phone (918) 775-9150

Hospital & facility affiliations

  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
  • Northeastern Health System Hospital, Tahlequah, OK, CCN 370089
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203920OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Mar 31, 2023 Accepting new patients
Cherokee Nation CurrentSince Mar 31, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
JP Fitness Health and Travel Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1114599081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S J T STITES ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749559302",
            "telephone_number": "918-774-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S J T STITES ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749559302",
            "telephone_number": "918-774-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 W Choctaw Ave",
            "address_purpose": "LOCATION",
            "city": "Sallisaw",
            "state": "OK",
            "postal_code": "749554416",
            "country_code": "US",
            "telephone_number": "918-271-6058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "203920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288261758",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288261758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

Verify at the official NPI Registry.