Individual provider Active NPI

Damarcus Rocheon Nelson, APRN

  • Family Nurse Practitioner
  • Yukon, OK
National Provider Identifier
1194080499
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
90736 Issued in OK
Practice address
11109 Surrey Hills Blvd
Yukon, OK 73099-8155
Phone
(405) 373-2400
Fax
(405) 373-4400
NPI assigned
Jul 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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 90736 OK Primary

Addresses

Primary practice location

11109 Surrey Hills Blvd
Yukon, OK 73099-8155

Mailing address

PO Box 660
Piedmont, OK 73078-0660
Phone (405) 373-2400

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
I20130301000246 OK Practitioner - Nurse Practitioner 8123273877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Health Care and Minor Emergency Clinic IncGroup PAC ID 8729075650, 3 clinicians

Practice addresses (Care Compare)

11109 Surrey Hills Blvd
Yukon, OK 73099-8155
Phone (405) 373-2400

Hospital & facility affiliations

  • Best Choice Home Health Inc Home health agency, Oklahoma City, OK, CCN 377764
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care & Minor Emergency Clinic Inc CurrentSince Jan 20, 2013 Accepting new patients
Neighborhood Family Clinic & Minor CurrentSince May 6, 2013 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

6102 NW 63rd St
Ste A
Oklahoma City, OK 73132
Phone (405) 373-2400

6102 NW 63rd St
Ste B
Oklahoma City, OK 73132
Phone (405) 373-2400

2501 N Blackwelder Ave
Oklahoma City, OK 73106
Phone (405) 208-5000

6102 NW 63rd St
#B
Oklahoma City, OK 73132
Phone (405) 373-2400

11109 Surrey Hills Blvd
Yukon, OK 73099
Phone (405) 373-2400

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 2

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1194080499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730780660",
            "telephone_number": "405-373-2400",
            "fax_number": "405-373-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 SURREY HILLS BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998155",
            "telephone_number": "405-373-2400",
            "fax_number": "405-373-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DAMARCUS",
        "middle_name": "ROCHEON",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "90736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.