Active NPI
Jennifer Rebecca Gonzales, APRN, CNP
- Pediatric Nurse Practitioner
- Owasso, OK
National Provider Identifier
1316486509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 71867
- Practice address
- 12455 E 100TH St N Ste 300
Owasso, OK 74055-4678 - Phone
- (918) 274-9700
- Fax
- (918) 274-1395
- NPI assigned
- Feb 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 71867 | OK | Primary |
Addresses
Primary practice location
12455 E 100TH St N Ste 300
Owasso, OK 74055-4678
Mailing address
12455 E 100TH St N Ste 300
Owasso, OK 74055-4678
Phone (918) 274-9700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71867 | OK | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1316486509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12455 E 100TH ST N STE 300",
"city": "OWASSO",
"state": "OK",
"postal_code": "740554678",
"telephone_number": "918-274-9700",
"fax_number": "918-274-1395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12455 E 100TH ST N STE 300",
"city": "OWASSO",
"state": "OK",
"postal_code": "740554678",
"telephone_number": "918-274-9700",
"fax_number": "918-274-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "JENNIFER",
"middle_name": "REBECCA",
"credential": "APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-21",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OK",
"license": "71867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.