Individual provider Active NPI

Rose H. Autaubo, LPN

  • Licensed Practical Nurse
  • Anadarko, OK
National Provider Identifier
1124484324
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
24706 Issued in OK
Practice address
201 East Parker McKenzie Drive
Anadarko, OK 73005
Phone
(405) 247-7935
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 24706 OK Primary

Addresses

Primary practice location

201 East Parker McKenzie Drive
Anadarko, OK 73005

Mailing address

201 East Parker McKenzie Drive
Anadarko, OK 73005
Phone (405) 247-7935

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24706OKMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1124484324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EAST PARKER MCKENZIE DRIVE",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "73005",
            "telephone_number": "405-247-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST PARKER MCKENZIE DRIVE",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "73005",
            "telephone_number": "405-247-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTAUBO",
        "first_name": "ROSE",
        "middle_name": "H.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "24706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anadarko, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.