Individual provider Active NPI

Chelsea Jordan Chavez, FNP

  • Family Nurse Practitioner
  • Bartlesville, OK
National Provider Identifier
1124725577
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
212054 Issued in OK
Practice address
3400 E Frank Phillips Blvd
Bartlesville, OK 74006-2495
Phone
(918) 331-2415
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0124670 OK
Family Nurse Practitioner 363LF0000X 212054 OK Primary

Addresses

Primary practice location

3400 E Frank Phillips Blvd
Bartlesville, OK 74006-2495

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 403-7066

Other names 1

  • Chelsea Jordan Thomas Former name

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
I20230515000132 OK Practitioner - Nurse Practitioner 0749646966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

13600 E 86TH St N
Suite 100
Owasso, OK 74055-8732
Phone (918) 272-9313

Hospital & facility affiliations

  • St John Owasso Hospital, Owasso, OK, CCN 370227
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0124670OKMDRegistered Nurse
212054OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc CurrentSince Nov 6, 2023 Accepting new patients
St. John Physicians, Inc. CurrentSince Apr 3, 2023 Accepting new patients
St. John Physicians, Inc CurrentSince Apr 3, 2023 Accepting new patients

Locations

3400 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-2441

13600 E 86th St N
Ste 100
Owasso, OK 74055
Phone (918) 272-9313

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 3

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 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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1124725577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-403-7066",
            "fax_number": "918-744-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062495",
            "telephone_number": "918-331-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "CHELSEA",
        "middle_name": "JORDAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0124670",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "212054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "THOMAS",
            "middle_name": "JORDAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.