Individual provider Active NPI

Samantha Rae Quickle, FNP-C

  • Family Nurse Practitioner
  • Fort Sill, OK
National Provider Identifier
1184273583
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
122191 Issued in OK
Practice address
4700 Mow Way Rd
Fort Sill, OK 73503-4493
Phone
(580) 678-9345
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 122191 OK Primary

Addresses

Primary practice location

4700 Mow Way Rd
Fort Sill, OK 73503-4493

Mailing address

4301 Wilson St
Fort Sill, OK 73503-4472
Phone (580) 558-2635

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
I20220503002865 OK Practitioner - Nurse Practitioner 8224464441 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122191OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Oklahoma, PLLC CurrentSince Jun 1, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

2716 W Gore Blvd
Ste C
Lawton, OK 73505
Phone (580) 357-3280

2716 W Gore Blvd
Lawton, OK 73505
Phone (380) 357-3280

Organizations & group practices 4

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1184273583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MOW WAY RD",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034493",
            "telephone_number": "580-678-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICKLE",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "122191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.