NPIMap

Individual provider Active NPI

Amanda Lynn Lafarlette, APRNC-NP

  • Nurse Practitioner
  • Elk City, OK
National Provider Identifier
1255343638
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0044560 Issued in OK
Practice address
411 N Randall Ave
Elk City, OK 73644-4127
Phone
(580) 243-2273
Fax
(580) 243-2832
NPI assigned
Aug 13, 2006
Last updated
Dec 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0044560 OK Primary

Addresses

Primary practice location

411 N Randall Ave
Elk City, OK 73644-4127

Mailing address

411 N Randall Ave
Elk City, OK 73644-4127
Phone (580) 243-2273

Other identifiers 1

IdentifierTypeStateIssuer
200081520BMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000741 OK Practitioner - Nurse Practitioner 4981613221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erick Derocher DO IncGroup PAC ID 0547271504, 2 clinicians

Practice addresses (Care Compare)

411 N Randall Ave
Elk City, OK 73644-4127
Phone (580) 243-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as individual
Quality
97.53
Promoting interoperability
100
Improvement activities
40
Cost
92.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0044560OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erick Derocher D O Inc CurrentSince Mar 1, 2006 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Farmers Union Hospital Association Past Accepting new patients
Panhandle Womens Center P L L C Past Accepting new patients
Summit Medical Center Past Accepting new patients
Alacrity Healthcare, LLC PastSince Apr 21, 2015 Accepting new patients

Locations

411 N Randall Ave
Elk City, OK 73644
Phone (580) 243-2273

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIAJCA/Endpoint/BIAJCA

Organizations & group practices 6

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 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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1255343638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N RANDALL AVE",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444127",
            "telephone_number": "580-243-2273",
            "fax_number": "580-243-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N RANDALL AVE",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444127",
            "telephone_number": "580-243-2273",
            "fax_number": "580-243-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFARLETTE",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "APRNC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0044560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200081520B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.