Individual provider Active NPI

Slade Dollarhide

  • Family Nurse Practitioner
  • Valliant, OK
National Provider Identifier
1114789575
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
220185 Issued in OK
Practice address
101 E Terri Dr
Valliant, OK 74764-6801
Phone
(580) 933-9300
NPI assigned
Jan 30, 2024
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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 220185 OK Primary
Registered Nurse 163W00000X R0131124 OK

Addresses

Primary practice location

101 E Terri Dr
Valliant, OK 74764-6801

Mailing address

8794 Goodwater Rd
Haworth, OK 74740-5396

Other practice location 1

1425 E Lincoln Rd Ste B3
Idabel, OK 74745-7345
Phone (580) 286-2947

Other practice location 2

8794 Goodwater Rd
Haworth, OK 74740-5396
Phone (580) 612-6560

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
I20241115001306 OK Practitioner - Nurse Practitioner 9436683281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1315 S Lynn LN
Idabel, OK 74745-6845
Phone (580) 286-2947

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0131124OKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
McCurtain Memorial Medical Management, Inc. CurrentSince Sep 7, 2024 Accepting new patients
McCurtain Memorial Medical Management, Inc. CurrentSince Sep 7, 2024 Accepting new patients
McCurtain Memorial Medical Management, Inc. Current Accepting new patients
McCurtain Memorial Medical Management, Inc. Past Accepting new patients

Locations

1301 E Lincoln Rd
Idabel, OK 74745
Phone (580) 208-3103

1315 S Lynn Ln
Idabel, OK 74745
Phone (580) 286-2947

1425 E Lincoln Rd
Ste B3
Idabel, OK 74745
Phone (580) 286-2947

101 E Terri Dr
Valliant, OK 74764
Phone (580) 933-9025

Interoperability endpoints

  • Direct secure messaging: slade.dollarhide.1@19961.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1114789575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8794 GOODWATER RD",
            "city": "HAWORTH",
            "state": "OK",
            "postal_code": "747405396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E TERRI DR",
            "city": "VALLIANT",
            "state": "OK",
            "postal_code": "747646801",
            "telephone_number": "580-933-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 E Lincoln Rd Ste B3",
            "address_purpose": "LOCATION",
            "city": "Idabel",
            "state": "OK",
            "postal_code": "747457345",
            "country_code": "US",
            "telephone_number": "580-286-2947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8794 Goodwater Rd",
            "address_purpose": "LOCATION",
            "city": "Haworth",
            "state": "OK",
            "postal_code": "747405396",
            "country_code": "US",
            "telephone_number": "580-612-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLLARHIDE",
        "first_name": "SLADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "220185",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0131124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valliant, OK

Sources for this page

Verify at the official NPI Registry.