Individual provider Active NPI

Patrecia Ann Fite, ARNP

  • Pediatric Nurse Practitioner
  • Mangum, OK
National Provider Identifier
1336356500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0025234 Issued in OK
Practice address
2100 North Louis Tittle Ave
Box 1
Mangum, OK 73554
Phone
(580) 782-5531
NPI assigned
May 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0025234 OK Primary

Addresses

Primary practice location

2100 North Louis Tittle Ave
Box 1
Mangum, OK 73554

Mailing address

306 N Alpha Ave
Box 454
Mangum, OK 73554-3602
Phone (580) 782-3702

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

State licenses

LicenseStateTypeSpecialty
0025234OKMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336356500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N ALPHA AVE",
            "address_2": "BOX 454",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735543602",
            "telephone_number": "580-782-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NORTH LOUIS TITTLE AVE",
            "address_2": "BOX 1",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "73554",
            "telephone_number": "580-782-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITE",
        "first_name": "PATRECIA",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "0025234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangum, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.