Individual provider Active NPI

Wynter Williams Kipgen, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Stillwater, OK
National Provider Identifier
1366434300
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
18443 Issued in OK
Practice address
1202 W Farm Rd
Stillwater, OK 74078-4226
Phone
(405) 744-7665
Fax
(405) 744-2059
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 18443 OK Primary

Addresses

Primary practice location

1202 W Farm Rd
Stillwater, OK 74078-4226

Mailing address

1202 W Farm Rd
Stillwater, OK 74078-4226
Phone (405) 744-7665

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301001027 OK Practitioner - Endocrinology 7618920646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1101 S Belmont
Suite 204
Okmulgee, OK 74447

1101 S Belmont Ave
Suite 204
Okmulgee, OK 74447-6315

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University CurrentSince Feb 1, 2024 Accepting new patients
Stillwater Medical Center Authority CurrentSince Jul 15, 2016 Accepting new patients
Stillwater Medical Center Authority CurrentSince Jul 15, 2016 Accepting new patients
Oklahoma State University CurrentSince Feb 1, 2024 Accepting new patients
State of Oklahoma Past Accepting new patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

809 S Walnut St
Stillwater, OK 74074
Phone (405) 533-5041

604 S Walnut St
Stillwater, OK 74074
Phone (405) 338-7072

Dept 2563
Tulsa, OK 74182

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

Interoperability endpoints

  • Direct secure messaging: wyneter.kipgen.d1.p1@direct.smc.nextgenshare.com

Organizations & group practices 7

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1366434300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W FARM RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740784226",
            "telephone_number": "405-744-7665",
            "fax_number": "405-744-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W FARM RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740784226",
            "telephone_number": "405-744-7665",
            "fax_number": "405-744-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPGEN",
        "first_name": "WYNTER",
        "middle_name": "WILLIAMS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OK",
            "license": "18443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.