Individual provider Active NPI

Korissa Gillespie, APRN

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1376137141
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
219847 Issued in OK
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1902
Phone
(918) 494-1418
Fax
(918) 728-8036
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 79620 KS
Acute Care Nurse Practitioner 363LA2100X 219847 OK Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3361

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kgillespie25746@stormontvaildirect.org Direct COTTON O'NEIL CLINIC REVOCABLE TRUST
Direct Messaging Address kgillespie25746@stormontvaildirect.org Direct STORMONT-VAIL HEALTHCARE INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221107002338 AR Practitioner - Nurse Practitioner 3870900251 Reassigns benefits to 1 organization
I20241106002778 OK Practitioner - Nurse Practitioner 3870900251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3366 NW Expressway
200 Integris Neurology North
Oklahoma City, OK 73112-4416
Phone (405) 713-9930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79620KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Aug 25, 2025 Accepting new patients
Washington Regional Medical System CurrentSince Oct 1, 2022 Accepting new patients
Washington Regional Medical System CurrentSince Oct 1, 2022 Accepting new patients
Warren Clinic Inc CurrentSince Nov 11, 2024 Accepting new patients

Locations

3336 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 444-8827

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

3366 NW Expressway St
Ste 200
Oklahoma City, OK 73112
Phone (405) 713-9930

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: kgillespie541082@direct.integrisok.com
  • Direct secure messaging: korissagillespie@wrms.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1376137141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-1418",
            "fax_number": "918-728-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "KORISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "79620",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "219847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgillespie25746@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "COTTON O'NEIL CLINIC REVOCABLE TRUST",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgillespie25746@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "STORMONT-VAIL HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.