Individual provider Active NPI

Jasmyne Symone Petty, APRN-CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1376241661
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
210361 Issued in OK
Practice address
609 W Memorial Rd
Oklahoma City, OK 73114-2006
Phone
(405) 418-5400
Fax
(405) 418-5404
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 210361 OK Primary

Addresses

Primary practice location

609 W Memorial Rd
Oklahoma City, OK 73114-2006

Mailing address

609 W Memorial Rd
Oklahoma City, OK 73114-2006
Phone (405) 418-5400

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
I20230502001051 OK Practitioner - Nurse Practitioner 9537524285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

609 W Memorial Rd
Oklahoma City, OK 73114-2006
Phone (405) 418-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Apr 15, 2023 Accepting new patients
Saints Medical Group, LLC CurrentSince Apr 15, 2023 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

777 NW 63rd St
Ste 452
Oklahoma City, OK 73116

609 W Memorial Rd
Oklahoma City, OK 73114
Phone (405) 418-2676

Interoperability endpoints

  • Direct secure messaging: jwalker401968@direct-ehr-ssmhc.com

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 2

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1376241661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142006",
            "telephone_number": "405-418-5400",
            "fax_number": "405-418-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142006",
            "telephone_number": "405-418-5400",
            "fax_number": "405-418-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JASMYNE",
        "middle_name": "SYMONE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "210361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.