Individual provider Active NPI

Jessica Jo Peck, APRN

  • Family Nurse Practitioner
  • Bartlesville, OK
National Provider Identifier
1144934456
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211277 Issued in OK
Practice address
4140 SE Adams Rd
Bartlesville, OK 74006-8450
Phone
(539) 529-4802
Fax
(918) 214-8480
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 211277 OK Primary

Addresses

Primary practice location

4140 SE Adams Rd
Bartlesville, OK 74006-8450

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125

Other names 1

  • Jessica Jo Mattox 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
I20230307000246 OK Practitioner - Nurse Practitioner 9638542053 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
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

  • Angels Care Home Health of East Oklahoma Home health agency, Broken Arrow, OK, CCN 377171
  • Ascension St John Jane Phillips Hospital, Bartlesville, OK, CCN 370018
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
  • St John Owasso Hospital, Owasso, OK, CCN 370227

Merit-based Incentive Payment System (MIPS)

Final score
91.06 of 100Reported as apm
Quality
75.25
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Mar 5, 2023 Accepting new patients
Trucare Concepts LLC CurrentSince Jan 20, 2024 Accepting new patients
St. John Physicians, Inc. Current Accepting new patients
Warren Clinic Inc CurrentSince Oct 1, 2024 Accepting new patients
Jane Phillips Memorial Medical Center, Inc. Past Accepting new patients

Locations

3450 E Frank Phillips Blvd
Ste 400
Bartlesville, OK 74006
Phone (918) 338-3740

4140 SE Adams Rd
Bartlesville, OK 74006
Phone (918) 214-8251

802 N Wyandotte Ave
Dewey, OK 74029
Phone (918) 534-8222

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

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

Organizations & group practices 5

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 7

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1144934456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0125",
            "fax_number": "918-502-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 SE ADAMS RD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740068450",
            "telephone_number": "539-529-4802",
            "fax_number": "918-214-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JESSICA",
        "middle_name": "JO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "211277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MATTOX",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.