NR Yukon LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NR YUKON LLC

Doing business as

Nerve Renewal Yukon

Practice address

12801 NW 10TH St
Yukon, OK 73099-4175

Phone

(405) 914-6677

Fax

(405) 669-3517

NPI assigned

Aug 14, 2024

Organization subpart

No

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

Authorized official

Name

Timothy C Bales

Title

Ceo/Owner

Phone

(405) 953-7221

Specialties & licenses 2

Addresses

Other names 1

• Nerve Renewal Yukon Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ivy Cherian, APRN-CNP

  • Primary Care Nurse Practitioner
  • Yukon, OK
  • NPI 1578296042
  Medicare reassignment Care Compare group NPD
• Stephanie Renee Sims, ARNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1558786541
  Medicare reassignment Care Compare group NPD
• Jennifer Kathleen Hinkle, MD

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
  • NPI 1003057670
  Medicare reassignment NPD

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1336971860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161937",
            "telephone_number": "405-953-7221",
            "fax_number": "405-669-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 NW 10TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994175",
            "telephone_number": "405-914-6677",
            "fax_number": "405-669-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NR YUKON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "BALES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "405-953-7221"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nerve Renewal Yukon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nerve Renewal Yukon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anita Lynn Noland, RN CNIM
• Eric Nordgren, BC-HIS
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• Claudette F Nuboyin
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• Jakenzee Shiane Nuzum
• Obioha Chukwuma Nwabugwu

• Physical Medicine & Rehabilitation Physician in Yukon, OK
• Providers in Yukon, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.