Ketti Lynn Eddy, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0074528 Issued in OK

Practice address

105 E Industrial Rd Ste B
Guthrie, OK 73044-6971

Phone

(405) 919-7570

Fax

(405) 256-9748

NPI assigned

Jul 12, 2005

Last updated

Sep 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ketti.eddy@359482257768452.direct.elationemr.com

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.

• Fusion MD PLLC

  • Clinic/Center
  • Del City, OK
  • NPI 1770936452
  Medicare reassignment NPD
• Marshall County Hma LLC

  • Family Medicine Physician
  • Durant, OK
  • NPI 1356874374
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1194723239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 HUNTERS PATH",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730341627",
            "telephone_number": "405-919-7570",
            "fax_number": "405-256-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E INDUSTRIAL RD STE B",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730446971",
            "telephone_number": "405-919-7570",
            "fax_number": "405-256-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "KETTI",
        "middle_name": "LYNN",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0074528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle Ridge
• Eagle Ridge Family Treatment Center
• Eagle Ridge Family Treatment Center
• Eagle Ridge Institute
• Deborah Renee Easton
• Denise Ergang
• Everbloom Therapy & Co.
• Holly V Evers, MS, LPC
• Matthew Steven Farthing
• Leland Finn

• Family Nurse Practitioner in Guthrie, OK
• Providers in Guthrie, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.