Individual provider Active NPI

Myna Ruth Laughlin, ARNP

  • Family Nurse Practitioner
  • Durant, OK
National Provider Identifier
1366515389
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
45593 Issued in OK
Practice address
1705 N Washington Ave Ste C
Durant, OK 74701-2100
Phone
(580) 924-5439
Fax
(580) 366-5439
NPI assigned
Nov 16, 2006
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 530454 TX
Family Nurse Practitioner 363LF0000X 45593 OK Primary
Pediatric Nurse Practitioner 363LP0200X RR0045593 OK

Addresses

Primary practice location

1705 N Washington Ave Ste C
Durant, OK 74701-2100

Mailing address

135 Brandi LN
Durant, OK 74701-7404
Phone (580) 920-8504

Other identifiers 3

IdentifierTypeStateIssuer
R0045593OtherOKOK NURSING LICENSE
200101720AMedicaidOK
530454OtherTXTEXAS LICENSE

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
I20091027000731 OK Practitioner - Nurse Practitioner 9335226240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1705 N Washington Ave
Suite C
Durant, OK 74701-2100
Phone (580) 924-5439

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RR0045593OKMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Pediatrics, PLLC Family CurrentSince Jan 1, 2022 Accepting new patients
Summit Medical Center Past Accepting new patients
Durant Hma LLC Past Accepting new patients
Uhs of Texoma, Inc Past Accepting new patients

Locations

1705 N Washington Ave
Ste C
Durant, OK 74701
Phone (580) 920-8062

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1366515389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BRANDI LN",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017404",
            "telephone_number": "580-920-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 N WASHINGTON AVE STE C",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012100",
            "telephone_number": "580-924-5439",
            "fax_number": "580-366-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUGHLIN",
        "first_name": "MYNA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "530454",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "45593",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "RR0045593",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK NURSING LICENSE",
            "identifier": "R0045593",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200101720A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "530454",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.