Individual provider Active NPI

Mia Nathan

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1306655659
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
221259 Issued in OK
Practice address
3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone
(405) 949-3011
NPI assigned
Jan 2, 2025
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 221259 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Oklahoma City, OK 73112-4418

Mailing address

220 N Chris Ter
Mustang, OK 73064-6315
Phone (405) 543-3741

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
I20250326001115 OK Practitioner - Nurse Practitioner 0345763801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3366 NW Expressway
Suite 800
Oklahoma City, OK 73112-4458
Phone (405) 713-9935

3366 NW Expwy
Suite 800
Oklahoma City, OK 73112-4458

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

5501 N Portland
Select Specialty Hosp West
Oklahoma City, OK 73112-2074
Phone (405) 951-4016

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Mar 23, 2025 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3366 NW Expressway St
Ste 800
Oklahoma City, OK 73112
Phone (405) 713-9935

Interoperability endpoints

  • Direct secure messaging: mrabon148147@direct.integrisok.com

Organizations & group practices 2

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": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1306655659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N CHRIS TER",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730646315",
            "telephone_number": "405-543-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "MIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "221259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.