Individual provider Active NPI

Mallory Kitchell, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • McAlester, OK
National Provider Identifier
1164394813
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
225064 Issued in OK
Practice address
604 S 2ND St
McAlester, OK 74501-5814
Phone
(539) 316-2140
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 225064 OK Primary

Addresses

Primary practice location

604 S 2ND St
McAlester, OK 74501-5814

Mailing address

655 E Okmulgee St
Muskogee, OK 74403-5529
Phone (918) 915-7575

Other practice location 1

655 E Okmulgee St
Muskogee, OK 74403-5529
Phone (918) 915-7575

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
I20251215002479 OK Practitioner - Nurse Practitioner 6507350774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kind Mind Mental Health Professional CorporationGroup PAC ID 6002254836, 5 clinicians

Practice addresses (Care Compare)

655 E Okmulgee St
Muskogee, OK 74403-5529
Phone (918) 913-7575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
225064OKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kind Mind Mental Health Professional Corporation Psychiatric/Mental Health CurrentSince Nov 1, 2025 Accepting new patients
Choctaw Nation of Oklahoma PastSince Sep 28, 2025 Accepting new patients
Choctaw Nation Health Care System PastSince Sep 28, 2025 Accepting new patients

Locations

655 E Okmulgee St
Muskogee, OK 74403
Phone (918) 683-0981

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.

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1164394813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035529",
            "telephone_number": "918-915-7575",
            "fax_number": "918-915-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S 2ND ST",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015814",
            "telephone_number": "539-316-2140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Okmulgee St",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744035529",
            "country_code": "US",
            "telephone_number": "918-915-7575",
            "fax_number": "918-915-7576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITCHELL",
        "first_name": "MALLORY",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "225064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.