Individual provider Active NPI

Kenneth Brian Hurst, APRN-CNP

  • Family Nurse Practitioner
  • Muskogee, OK
National Provider Identifier
1194260703
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
205720 Issued in OK
Practice address
550 W Shawnee St
Muskogee, OK 74401-4144
Phone
(918) 910-5186
NPI assigned
Jan 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 205720 OK Primary
Emergency Registered Nurse 163WE0003X 77838 OK

Addresses

Primary practice location

550 W Shawnee St
Muskogee, OK 74401-4144

Mailing address

31349 W County Road 1235
Quinton, OK 74561-1012
Phone (918) 232-3159

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
I20211020003009 OK Practitioner - Nurse Practitioner 2567850795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12 E Macarthur St
Xpress Wellness Urgent Care
Shawnee, OK 74804-2135
Phone (405) 275-1001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77838OKMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Oct 11, 2021 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Oct 11, 2021 Accepting new patients
Williams Medical Group Practice, LLC Past Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

550 W Shawnee St
Muskogee, OK 74401
Phone (908) 910-5186

701 Cedar Lake Blvd
Ste 120
Oklahoma City, OK 73114
Phone (405) 286-1170

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

12 E MacArthur St
Shawnee, OK 74804
Phone (405) 275-1001

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1194260703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31349 W COUNTY ROAD 1235",
            "city": "QUINTON",
            "state": "OK",
            "postal_code": "745611012",
            "telephone_number": "918-232-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W SHAWNEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014144",
            "telephone_number": "918-910-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "KENNETH",
        "middle_name": "BRIAN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-05",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "205720",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OK",
            "license": "77838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.