Individual provider Active NPI

Tammi Kenemer, ARNP

  • Family Nurse Practitioner
  • Sayre, OK
National Provider Identifier
1255337499
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0050428 Issued in OK
Practice address
1415 Watts St
Sayre, OK 73662-1310
Phone
(580) 928-2044
Fax
(580) 928-5660
NPI assigned
Jun 22, 2005
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 R0050428 OK Primary

Addresses

Primary practice location

1415 Watts St
Sayre, OK 73662-1310

Mailing address

1415 Watts St
Sayre, OK 73662-1310
Phone (580) 928-2044

Other identifiers 1

IdentifierTypeStateIssuer
200011740AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0050428OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority PastSince Dec 31, 2008 Accepting new patients
Noble L Ballard.Medical Clinic, PLLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Organizations & group practices 3

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1255337499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WATTS ST",
            "city": "SAYRE",
            "state": "OK",
            "postal_code": "736621310",
            "telephone_number": "580-928-2044",
            "fax_number": "580-928-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WATTS ST",
            "city": "SAYRE",
            "state": "OK",
            "postal_code": "736621310",
            "telephone_number": "580-928-2044",
            "fax_number": "580-928-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENEMER",
        "first_name": "TAMMI",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0050428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200011740A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.