NPIMap

Individual provider Active NPI

Katherine Denise Lynn Green, APRN

  • Family Nurse Practitioner
  • Holdenville, OK
National Provider Identifier
1295434512
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
212052 Issued in OK
Practice address
100 McDougal Dr
Holdenville, OK 74848-2899
Phone
(405) 379-4202
Fax
(405) 379-4340
NPI assigned
Feb 24, 2023
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 212052 OK Primary
Registered Nurse 163W00000X R0089984 OK

Addresses

Primary practice location

100 McDougal Dr
Holdenville, OK 74848-2899

Mailing address

100 McDougal Dr
Holdenville, OK 74848-2899
Phone (405) 379-4202

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
I20230509000372 OK Practitioner - Nurse Practitioner 9436514809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holdenville General Hospital Scholarship Fund IncGroup PAC ID 0345152153, 5 clinicians
Holdenville Hospital AuthorityGroup PAC ID 6002031424, 10 clinicians
Icare Center LLCGroup PAC ID 0840555777, 28 clinicians

Practice addresses (Care Compare)

100 McDougal Dr
Holdenville, OK 74848-2822

2903 W Britton Rd
Oklahoma City, OK 73120-4433
Phone (405) 849-4650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0089984OKMDRegistered Nurse
212052OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holdenville Hospital Authority CurrentSince Apr 1, 2023 Accepting new patients
Holdenville Hospital Authority Current Accepting new patients
Icare Center LLC CurrentSince Dec 5, 2023 Accepting new patients
Holdenville Hospital Authority CurrentSince Apr 1, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients
Holdenville Hospital Authority Past Accepting new patients

Locations

100 McDougal Dr
Holdenville, OK 74848
Phone (405) 379-4200

2903 W Britton Rd
Oklahoma City, OK 73120
Phone (405) 755-8028

1401 W 1st St
Wewoka, OK 74884
Phone (405) 257-3396

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 8

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": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1295434512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCDOUGAL DR",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748482899",
            "telephone_number": "405-379-4202",
            "fax_number": "405-379-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCDOUGAL DR",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748482899",
            "telephone_number": "405-379-4202",
            "fax_number": "405-379-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATHERINE",
        "middle_name": "DENISE LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "212052",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0089984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdenville, OK

Sources for this page

Verify at the official NPI Registry.