Individual provider Active NPI

Alisha Jo Whitebird, DNP, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Wynnewood, OK
National Provider Identifier
1124619879
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R0122164 Issued in OK
Practice address
114 S Dean a McGee Ave
Wynnewood, OK 73098-7822
Phone
(405) 276-3553
NPI assigned
Jan 26, 2021
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R0122164 OK Primary

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

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
I20230317000346 OK Practitioner - Nurse Practitioner 1254724966 Reassigns benefits to 1 organization
Practice locations: Wynnewood, OK

Care Compare profile

Medicare Care Compare
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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Matters Medical Clinic LLC CurrentSince Jan 20, 2023 Accepting new patients
Advantmed Provider Network PastSince Jul 1, 2022 Accepting new patients

Locations

114 S Dean a McGee Ave
Wynnewood, OK 73098
Phone (405) 276-3553

Organizations & group practices 2

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 3

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1124619879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S DEAN A MCGEE AVE",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730987822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S DEAN A MCGEE AVE",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730987822",
            "telephone_number": "405-276-3553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1751 E Garry Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927055814",
            "country_code": "US",
            "telephone_number": "949-313-7934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEBIRD",
        "first_name": "ALISHA",
        "middle_name": "JO",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "R0122164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, OK

Sources for this page

Verify at the official NPI Registry.