Wynnewood Wellness Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

WYNNEWOOD WELLNESS CLINIC

Practice address

1202 E Kerr Blvd
Wynnewood, OK 73098-2054

Phone

(405) 473-3307

NPI assigned

Nov 1, 2022

Last updated

Nov 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Karisa Jo Kennedy, APRNNPI 1053623728

Title

Aprn

Phone

(405) 473-3307

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karisa Jo Kennedy, NP

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1053623728
  NPD Authorized official

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1265149140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 SW 82ND CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731595943",
            "telephone_number": "405-473-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E KERR BLVD",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730982054",
            "telephone_number": "405-473-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNEWOOD WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KARISA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "405-473-3307",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon D. Wheeler, R.D./L.D.
• Alisha Jo Whitebird, DNP, APRN, FNP-C
• Wynnewood Nursing Center LLC (Grace Living Center - Wynnewood)
• Wynnewood Public Schools
• Wynnewood Urgent Care and Immediate Care Center PC

• Rural Health Clinic/Center in Wynnewood, OK
• Providers in Wynnewood, OK by specialty
• Rural Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.