Individual provider Active NPI

Divya Joykutty, APRN

  • Primary Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1336370113
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
72409 Issued in OK
Practice address
10700 S Pennsylvania Ave
Oklahoma City, OK 73170-4207
Phone
(405) 691-9700
Fax
(405) 691-9702
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 72409 OK
Primary Care Nurse Practitioner 363LP2300X 72409 OK Primary

Addresses

Primary practice location

10700 S Pennsylvania Ave
Oklahoma City, OK 73170-4207

Mailing address

10700 S Pennsylvania Ave
Oklahoma City, OK 73170-4207
Phone (405) 691-9700

Other identifiers 1

IdentifierTypeStateIssuer
200254270AMedicaidOK

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
I20090828000551 OK Practitioner - Nurse Practitioner 9133274087 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72409OKMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Jun 12, 2023 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 1, 2011 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Health Services Inc. Past Accepting new patients
Mercy Health Network Inc Past Accepting new patients

Locations

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

1121 NW 63rd St
Ste 5001
Nichols Hills, OK 73116
Phone (405) 652-0632

4345 W Memorial Rd
Ste 110
Oklahoma City, OK 73134
Phone (405) 749-7099

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

1919 E Memorial Rd
Oklahoma City, OK 73131
Phone (405) 341-7009

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1336370113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 S PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704207",
            "telephone_number": "405-691-9700",
            "fax_number": "405-691-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 S PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731704207",
            "telephone_number": "405-691-9700",
            "fax_number": "405-691-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYKUTTY",
        "first_name": "DIVYA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "72409",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "72409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200254270A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.