White Lotus Family Medicine & Aesthetics, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

WHITE LOTUS FAMILY MEDICINE & AESTHETICS, PLLC

Practice address

1407 E Main St Unit B
Stigler, OK 74462-2910

Phone

(918) 443-0200

NPI assigned

Jul 24, 2024

Organization subpart

No

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

Authorized official

Name

Kimberly D Smith

Title

Credentialing Specialist

Phone

(405) 984-7174

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Rene Decker, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Stigler, OK
  • NPI 1083867444
  Medicare reassignment NPD

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1366270902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744620052",
            "telephone_number": "918-443-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 E MAIN ST UNIT B",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622910",
            "telephone_number": "918-443-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE LOTUS FAMILY MEDICINE & AESTHETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "405-984-7174"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzzie J Waldenville, P.A.-C
• Raymond G Walker, LCSW
• Brandon Ray Wann
• Phyllis Leon Wann
• Faisal Wasi, MD
• Hannah Faith White, APRN-FNP-BC
• Shannon Lee White
• Cary Vonn Wickersham
• Kirsten Wilson
• Taylor Nicole Wingo

• Family Nurse Practitioner in Stigler, OK
• Providers in Stigler, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.