Individual provider Active NPI

Dachaunda Twynette Pete, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1326684903
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
87077 Issued in OK
Practice address
1055 S Houston Ave W
Tulsa, OK 74127-9014
Phone
(918) 921-3200
NPI assigned
Nov 19, 2019
Last updated
Nov 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 87077 OK Primary

Addresses

Primary practice location

1055 S Houston Ave W
Tulsa, OK 74127-9014

Mailing address

706 North Country Club Drive
Tulsa, OK 74127
Phone (918) 855-3826

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
I20200203001834 OK Practitioner - Nurse Practitioner 1254767643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 S Houston Ave
Tulsa, OK 74127-9043
Phone (918) 921-3200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87077OKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Services, Inc CurrentSince Dec 21, 2019 Accepting new patients
Family & Children's Services, Inc CurrentSince Dec 21, 2019 Accepting new patients

Locations

1055 S Houston Ave
Tulsa, OK 74127
Phone (918) 382-3100

650 S Peoria Ave
Tulsa, OK 74120
Phone (918) 560-1200

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.

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1326684903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 NORTH COUNTRY CLUB DRIVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74127",
            "telephone_number": "918-855-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 S HOUSTON AVE W",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279014",
            "telephone_number": "918-921-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETE",
        "first_name": "DACHAUNDA",
        "middle_name": "TWYNETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "87077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.