Kerri Lynn Vandiver, ARNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

R0072206 Issued in OK

Practice address

11515 E 31St St
Tulsa, OK 74146-1908

Phone

(918) 392-3944

Fax

(918) 392-3949

NPI assigned

Nov 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Community Health Connection Inc

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
  • NPI 1194730911
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1366423188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741461908",
            "telephone_number": "918-392-3944",
            "fax_number": "918-392-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741461908",
            "telephone_number": "918-392-3944",
            "fax_number": "918-392-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R0072206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Faith Vanderveen, SLP
• Kristin Vandervoort, O.D.
• Chelsea Vanderwall, DO
• Lindsey Brook Vandeventer, LCSW
• Jonah R.B. Vandiver, D.D.S.
• Brianna Alexis Vandoren
• Bryan Andrew Vandoren, M.D.
• Jessica Vandyk, LAT, ATC
• Erica Vanfleet
• Ana Vang

• Women's Health Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Women's Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.