Individual provider Active NPI

Kayti Moxley, APRN-CNP

  • Family Nurse Practitioner
  • Ponca City, OK
National Provider Identifier
1346650397
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0058951 Issued in OK
Practice address
122 E Grand Ave
Ponca City, OK 74601-5205
Phone
(580) 302-8270
Fax
(580) 749-5682
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0058951 OK Primary

Addresses

Primary practice location

122 E Grand Ave
Ponca City, OK 74601-5205

Mailing address

212 N Main St
Fairfax, OK 74637-3023
Phone (918) 642-3100

Other practice location 1

212 N Main St
Fairfax, OK 74637-3023
Phone (918) 642-3100

Other practice location 2

716 S Highway 77
Newkirk, OK 74647-7009
Phone (580) 362-2555

Other practice location 3

119 W Main St
Hominy, OK 74035-1031
Phone (918) 885-4640

Other names 1

  • Kayti Montgomery Former name

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
I20160512001164 OK Practitioner - Nurse Practitioner 4688892797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfax Medical Facilities IncGroup PAC ID 4284663360, 16 clinicians

Practice addresses (Care Compare)

122 E Grand Ave
Ponca City, OK 74601-5205
Phone (580) 203-8270

212 N Main St
Fairfax, OK 74637-3023
Phone (918) 642-3100

716 S Hwy 77
Newkirk, OK 74647-7009
Phone (918) 642-3100

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
81.07
Promoting interoperability
86
Improvement activities
40
Cost
69.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0058951OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Medical Facilities Inc CurrentSince Sep 9, 2024 Accepting new patients
McBride Clinic Orthopedic Hospital, LLC CurrentSince May 9, 2016 Accepting new patients
Fairfax Medical Facilities, Inc. CurrentSince Sep 9, 2024 Accepting new patients
Fairfax Medical Facilities Inc Past Accepting new patients
Fairfax Medical Facilities Inc Past Accepting new patients

Locations

212 N Main St
Fairfax, OK 74637
Phone (918) 642-3100

119 W Main St
Hominy, OK 74035
Phone (918) 497-8138

716 S Highway 77
Newkirk, OK 74647
Phone (580) 362-2555

1110 N Lee Ave
Oklahoma City, OK 73103
Phone (405) 232-0341

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

122 E Grand Ave
Ponca City, OK 74601
Phone (580) 203-8270

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGHIAA

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1346650397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N MAIN ST",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746373023",
            "telephone_number": "918-642-3100",
            "fax_number": "918-642-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E GRAND AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746015205",
            "telephone_number": "580-302-8270",
            "fax_number": "580-749-5682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 N Main St",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "OK",
            "postal_code": "746373023",
            "country_code": "US",
            "telephone_number": "918-642-3100",
            "fax_number": "918-642-5639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "716 S Highway 77",
            "address_purpose": "LOCATION",
            "city": "Newkirk",
            "state": "OK",
            "postal_code": "746477009",
            "country_code": "US",
            "telephone_number": "580-362-2555",
            "fax_number": "580-362-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 W Main St",
            "address_purpose": "LOCATION",
            "city": "Hominy",
            "state": "OK",
            "postal_code": "740351031",
            "country_code": "US",
            "telephone_number": "918-885-4640",
            "fax_number": "918-885-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOXLEY",
        "first_name": "KAYTI",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0058951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYTI",
            "last_name": "MONTGOMERY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ponca City, OK

Sources for this page

Verify at the official NPI Registry.