Individual provider Active NPI

Bethany Dianna Brown, CNP

  • Family Nurse Practitioner
  • Yukon, OK
National Provider Identifier
1366848798
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
89019 Issued in OK
Practice address
836 Garth Brooks Blvd Ste 215
Yukon, OK 73099-3890
Phone
(405) 494-3370
Fax
(405) 494-3371
NPI assigned
Nov 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 89019 OK Primary

Addresses

Primary practice location

836 Garth Brooks Blvd Ste 215
Yukon, OK 73099-3890

Mailing address

4345 W Memorial Rd
Oklahoma City, OK 73134-1702
Phone (405) 494-3370

Other practice location 1

5201 W Memorial Rd
Oklahoma City, OK 73142-2004
Phone (405) 755-4050

Other practice location 2

206 N Mustang Mall Ter
Mustang, OK 73064-5135
Phone (405) 353-3150

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
I20150112000458 OK Practitioner - Nurse Practitioner 1658695101 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

5201 W Memorial Rd
Oklahoma City, OK 73142-2004
Phone (405) 755-4050

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89019OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Logan County, Inc CurrentSince Jun 1, 2024 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Jun 1, 2024 Accepting new patients
Mercy Hospital Logan County Inc CurrentSince Jun 1, 2024 Accepting new patients
Minuteclinic Video Virtual Care, PLLC Family CurrentSince Apr 3, 2023 Accepting new patients
Mercy Hospital Oklahoma City, Inc PastSince Jun 23, 2025 Accepting new patients

Locations

1520 S Bryant Ave
Edmond, OK 73013
Phone (405) 348-7980

2919 S Division St
Guthrie, OK 73044
Phone (405) 282-6301

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

5201 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 755-4050

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

836 Garth Brooks Blvd
Ste 215
Yukon, OK 73099
Phone (405) 494-3370

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.

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": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1366848798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341702",
            "telephone_number": "405-494-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 GARTH BROOKS BLVD STE 215",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993890",
            "telephone_number": "405-494-3370",
            "fax_number": "405-494-3371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 W Memorial Rd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731422004",
            "country_code": "US",
            "telephone_number": "405-755-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 N Mustang Mall Ter",
            "address_purpose": "LOCATION",
            "city": "Mustang",
            "state": "OK",
            "postal_code": "730645135",
            "country_code": "US",
            "telephone_number": "405-353-3150",
            "fax_number": "405-353-3186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BETHANY",
        "middle_name": "DIANNA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "89019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.