Individual provider Active NPI

Natausha Shauntrece Walker, FNP-C

  • Family Nurse Practitioner
  • Idabel, OK
National Provider Identifier
1215669189
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
208666 Issued in OK
Practice address
805 E Washington St
Idabel, OK 74745-3331
Phone
(580) 286-1095
Fax
(580) 286-3122
NPI assigned
Jun 28, 2022
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 208666 OK Primary

Addresses

Primary practice location

805 E Washington St
Idabel, OK 74745-3331

Mailing address

1425 E Lincoln Rd Suite B-3
Idabel, OK 74745
Phone (903) 933-6400

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
I20230509000242 OK Practitioner - Nurse Practitioner 2466817838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stathealth Clinic PLLCGroup PAC ID 2769652858, 2 clinicians

Practice addresses (Care Compare)

805 E Washington St
Idabel, OK 74745-3331
Phone (580) 286-1095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208666OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stathealth Clinic PLLC CurrentSince Apr 13, 2025 Accepting new patients
Ascension Health and Wellness PLLC Family PastSince Jul 1, 2022 Accepting new patients

Locations

805 E Washington St
Idabel, OK 74745
Phone (580) 286-1095

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: threadgill03@scp-ok.direct.office.nextgen.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1215669189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 E LINCOLN RD SUITE B-3",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "74745",
            "telephone_number": "903-933-6400",
            "fax_number": "580-286-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E WASHINGTON ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747453331",
            "telephone_number": "580-286-1095",
            "fax_number": "580-286-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "NATAUSHA",
        "middle_name": "SHAUNTRECE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "208666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.