Individual provider Active NPI

Lori Kimberly Scott, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1235603606
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
123944 Issued in OK
Practice address
4320 Avalon CT
Oklahoma City, OK 73120-8175
Phone
(405) 328-4380
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 123944 OK
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 123944 OK Primary

Addresses

Primary practice location

4320 Avalon CT
Oklahoma City, OK 73120-8175

Mailing address

12101 N Macarthur Blvd
Oklahoma City, OK 73162-1800
Phone (405) 328-4380

Other identifiers 1

IdentifierTypeStateIssuer
000000000MedicaidOK

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
I20190225000410 OK Practitioner - Nurse Practitioner 7911246608 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123944OKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Apr 1, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

550 W Shawnee St
Muskogee, OK 74401
Phone (908) 910-5186

7127 S Olympia Ave
Tulsa, OK 74132
Phone (918) 665-9500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1235603606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 N MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731621800",
            "telephone_number": "405-328-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 AVALON CT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208175",
            "telephone_number": "405-328-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LORI",
        "middle_name": "KIMBERLY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "123944",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "123944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.