NPIMap

Individual provider Active NPI

Phyllis A. Peace, APRN

  • Family Nurse Practitioner
  • Owasso, OK
National Provider Identifier
1225434756
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
79303 Issued in OK
Practice address
12455 E 100TH St N Ste 300
Owasso, OK 74055-4678
Phone
(918) 274-9700
Fax
(918) 274-1395
NPI assigned
Nov 11, 2014
Last updated
Nov 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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 79303 OK Primary

Addresses

Primary practice location

12455 E 100TH St N Ste 300
Owasso, OK 74055-4678

Mailing address

12455 E 100TH St N Ste 300
Owasso, OK 74055-4678
Phone (918) 274-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150512002106 OK Practitioner - Nurse Practitioner 9830418904 Reassigns benefits to 2 organizations
I20250416003782 TX Practitioner - Nurse Practitioner 9830418904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

508 Hwy 271 N
Antlers Community Clinic
Antlers, OK 74523
Phone (539) 316-6391

One Choctaw Way
Talihina, OK 74571-2022

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79303OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University CurrentSince Dec 1, 2024 Accepting new patients
Oklahoma State University CurrentSince Dec 1, 2024 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Apr 14, 2025 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Oklahoma State University Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Apr 14, 2025 Accepting new patients
Ahs Oklahoma Heart LLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

508 Highway 271 N
Antlers, OK 74523
Phone (580) 326-9725

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8440

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

Dept 1218
Tulsa, OK 74182

Dept 2563
Tulsa, OK 74182

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1225434756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 300",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554678",
            "telephone_number": "918-274-9700",
            "fax_number": "918-274-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 300",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554678",
            "telephone_number": "918-274-9700",
            "fax_number": "918-274-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACE",
        "first_name": "PHYLLIS",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "79303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.