Individual provider Active NPI

Emily Kathryn Grewe-Nelson, D.O.

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1235543141
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6172 Issued in OK
Practice address
3316 E 21St St Ste a
Tulsa, OK 74114-1927
Phone
(918) 749-3533
Fax
(918) 749-9789
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014019165 MO
Family Medicine Physician 207Q00000X 6172 OK Primary

Addresses

Primary practice location

3316 E 21St St Ste a
Tulsa, OK 74114-1927

Mailing address

3316 E 21St St Ste a
Tulsa, OK 74114-1927
Phone (918) 749-3533

Other practice location 1

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-7751

Other identifiers 1

IdentifierTypeStateIssuer
200713610AMedicaidOK

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
I20170807000264 OK Practitioner - Family Practice 3375845399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

3316 E 21St St
Suite a
Tulsa, OK 74114-1927
Phone (918) 749-3533

Hospital & facility affiliations

  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6172OKMDProfessional Counselor
2014019165MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Aug 1, 2017 Accepting new patients
Summit Medical Center Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

Dept 1206
Tulsa, OK 74182

3316 E 21st St
Ste A
Tulsa, OK 74114
Phone (918) 749-1967

Interoperability endpoints

  • Direct secure messaging: egrewenelson106900@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 4

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 2

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235543141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 E 21ST ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141927",
            "telephone_number": "918-749-3533",
            "fax_number": "918-749-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 E 21ST ST STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141927",
            "telephone_number": "918-749-3533",
            "fax_number": "918-749-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391236",
            "country_code": "US",
            "telephone_number": "816-404-7751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREWE-NELSON",
        "first_name": "EMILY",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2014019165",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200713610A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.