NPIMap

Individual provider Active NPI

Kendra Ann Speight, ARNP

  • Family Nurse Practitioner
  • Shawnee, OK
National Provider Identifier
1184935496
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
69925 Issued in OK
Practice address
124 N Bell Ave
Shawnee, OK 74801-6902
Phone
(405) 275-1457
Fax
(405) 275-0067
NPI assigned
Jul 1, 2010
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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 69925 OK Primary

Addresses

Primary practice location

124 N Bell Ave
Shawnee, OK 74801-6902

Mailing address

124 N Bell Ave
Shawnee, OK 74801-6902
Phone (405) 275-1457

Other identifiers 2

IdentifierTypeStateIssuer
200459400AMedicaidOK
200459480AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@downtownclinic.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180226002363 OK Practitioner - Nurse Practitioner 9133377708 Receives reassigned benefits from 1 practitioner
Practice locations: Shawnee, OK

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 N Oklahoma Ave
Shawnee, OK 74801-7005
Phone (405) 514-1698

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69925OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Downtown Clinic Family PastSince Oct 1, 2012 Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: kspeight@tdc-ok.direct.office.nextgen.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1184935496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N BELL AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016902",
            "telephone_number": "405-275-1457",
            "fax_number": "405-275-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N BELL AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016902",
            "telephone_number": "405-275-1457",
            "fax_number": "405-275-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIGHT",
        "first_name": "KENDRA",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "69925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200459400A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200459480A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@downtownclinic.net",
            "affiliation": "N",
            "address_1": "124 N Bell Ave",
            "city": "Shawnee",
            "state": "OK",
            "country_code": "US",
            "postal_code": "748016902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.