Individual provider Active NPI

Katherine Clare Nordstrom, APRN-CNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1295136505
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
88936 Issued in OK
Practice address
9001 S 101St East Ave
Suite 230
Tulsa, OK 74133-5708
Phone
(918) 392-5470
Fax
(918) 294-6851
NPI assigned
Sep 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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 88936 OK Primary

Addresses

Primary practice location

9001 S 101St East Ave
Suite 230
Tulsa, OK 74133-5708

Mailing address

5730 E 102ND St
Tulsa, OK 74137
Phone (918) 625-6351

Other identifiers 1

IdentifierTypeStateIssuer
200575490AMedicaidOK

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
I20150221000003 OK Practitioner - Nurse Practitioner 3476878133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

Merit-based Incentive Payment System (MIPS)

Final score
64.75 of 100Reported as group
Quality
55.37
Improvement activities
40
Cost
47.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
88936OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Navigation LLC CurrentSince Jun 8, 2023 Accepting new patients
True North Health Navigation LLC CurrentSince Jun 8, 2023 Accepting new patients

Locations

2525 NW Expressway St
Ste 102
Oklahoma City, OK 73112
Phone (405) 213-0190

4853 S Sheridan Rd
Ste 612
Tulsa, OK 74145
Phone (405) 213-0192

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1295136505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 E 102ND ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74137",
            "telephone_number": "918-625-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 S 101ST EAST AVE",
            "address_2": "SUITE 230",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335708",
            "telephone_number": "918-392-5470",
            "fax_number": "918-294-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "KATHERINE",
        "middle_name": "CLARE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "88936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200575490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.