Individual provider Active NPI

Addison Lorraine Nakashima

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1295458008
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9154 Issued in OK
Practice address
1111 W 17TH St
Tulsa, OK 74107-1886
Phone
(918) 633-5560
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9154 OK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1111 W 17TH St
Tulsa, OK 74107-1886

Mailing address

13526 N 130TH East Ave
Collinsville, OK 74021-4492
Phone (918) 633-5560

Other practice location 1

200 2nd Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216003214 OK Practitioner - Emergency Medicine 4183119282 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagoner Hospital AuthorityGroup PAC ID 0042217531, 20 clinicians
South Central Emergency Services, PCGroup PAC ID 8224212949, 57 clinicians

Practice addresses (Care Compare)

1200 W Cherokee St
Wagoner, OK 74467-4624
Phone (918) 485-5514

200 2ND Ave SW
Miami, OK 74354-6830
Phone (918) 542-6611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9154OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Hospital Medicine Physicians Group, LLC CurrentSince Mar 12, 2026 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients

Locations

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

8801 S 101st East Ave
Tulsa, OK 74133
Phone (800) 965-4565

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Interoperability endpoints

  • Direct secure messaging: addison.nakashima.1@20767.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1295458008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13526 N 130TH EAST AVE",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740214492",
            "telephone_number": "918-633-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 17TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071886",
            "telephone_number": "918-633-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 2nd Ave SW",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "OK",
            "postal_code": "743546830",
            "country_code": "US",
            "telephone_number": "918-542-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAKASHIMA",
        "first_name": "ADDISON",
        "middle_name": "LORRAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "9154",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.