Individual provider Active NPI

Kyra Jean Vineyard, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1225005895
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3998 Issued in OK
Practice address
11917 S. Norwood Ave
Tulsa, OK 74137
Phone
(918) 392-5555
Fax
(918) 392-5566
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3998 OK Primary

Addresses

Primary practice location

11917 S. Norwood Ave
Tulsa, OK 74137

Mailing address

11917 S Norwood Ave Ste 212
Tulsa, OK 74137-5509
Phone (918) 392-5555

Other identifiers 1

IdentifierTypeStateIssuer
100102730AMedicaidOK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061012000644 OK Practitioner - Family Practice 8022014133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11917 S Norwood Ave
Suite 212
Tulsa, OK 74137-5509
Phone (918) 392-5555

Hospital & facility affiliations

  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3998OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vineyard Medical Care, LLC Family Medicine CurrentSince Feb 25, 2025 Accepting new patients
University Health Physicians Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Northeast Oklahoma Physician Network Inc Family Medicine Past Accepting new patients
Sjmgroup Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIHBDD
  • Direct secure messaging: kyra.vineyard@155130076790788.direct.elationemr.com
  • Direct secure messaging: kyra.vineyard.do.1@19843.direct.athenahealth.com

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 4

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1225005895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11917 S NORWOOD AVE STE 212",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375509",
            "telephone_number": "918-392-5555",
            "fax_number": "918-392-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11917 S. NORWOOD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74137",
            "telephone_number": "918-392-5555",
            "fax_number": "918-392-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINEYARD",
        "first_name": "KYRA",
        "middle_name": "JEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100102730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.