Alisha Jo Whitebird, DNP, APRN, FNP-C
Individual provider Active NPI Primary Care Nurse Practitioner · Wynnewood, OK
NPI 1124619879 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1124619879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- R0122164 (OK)
- Practice address
- 114 S Dean a McGee Ave
Wynnewood, OK 73098-7822 - Phone
- (405) 276-3553
- NPI assigned
- Jan 26, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
114 S Dean a McGee Ave
Wynnewood, OK 73098-7822
Phone (405) 276-3553
Hospital & facility affiliations
- Lifespring Home Care
- Arbuckle Memorial Hospital Authority
- Mercy Hospital Ardmore, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230317000346 | OK | Practitioner - Nurse Practitioner | 1254724966 |
Reassigns benefits to 1 organization Practice locations: Wynnewood, OK |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0122164 | OK | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Matters Medical Clinic LLC | Current |
Accepting new patients | |
| Advantmed Provider Network | Past |
Accepting new patients |
Locations
114 S Dean a McGee Ave
Wynnewood, OK 73098
Phone (405) 276-3553
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | R0122164 | OK | Yes |
Addresses
Primary practice location
114 S Dean a McGee Ave
Wynnewood, OK 73098-7822
Mailing address
114 S Dean a McGee Ave
Wynnewood, OK 73098-7822
Other practice location 1
1751 E Garry Ave
Santa Ana, CA 92705-5814
Phone (949) 313-7934
Other providers in Wynnewood, OK
- Avis M Taylor
- Paige Juhree Theissen
- William Wesley Webber
- Heather Wesberry
- Sharon D. Wheeler
- Wynnewood Nursing Center LLC
- Wynnewood Public Schools
- Wynnewood Urgent Care and Immediate Care Center PC
- Wynnewood Wellness Clinic
All providers in Wynnewood, OK · Primary Care Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.