NPIMap

Individual provider Active NPI

Kelley Frost Sky-Eagle, MS RD LD CDE

  • Registered Dietitian
  • Oklahoma City, OK
National Provider Identifier
1386004380
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD2123 Issued in OK
Practice address
1200 Childrens Ave Ste 4D
Oklahoma City, OK 73104-4637
Phone
(405) 271-5400
Fax
(405) 271-1127
NPI assigned
Mar 3, 2016
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1043935 NU
Registered Dietitian 133V00000X LD2123 OK Primary

Addresses

Primary practice location

1200 Childrens Ave Ste 4D
Oklahoma City, OK 73104-4637

Mailing address

1122 NE 13TH St # 262
Oklahoma City, OK 73117-1039
Phone (405) 271-5400

Other practice location 1

1717B S Utica Ave
Suite 205
Tulsa, OK 74104-5333
Phone (918) 744-2449

Other names 1

  • Kelley Michelle Frost Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD2123OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
St John Health System Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1386004380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST # 262",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-5400",
            "fax_number": "405-271-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 4D",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-5400",
            "fax_number": "405-271-1127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717B S Utica Ave",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045333",
            "country_code": "US",
            "telephone_number": "918-744-2449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKY-EAGLE",
        "first_name": "KELLEY",
        "middle_name": "FROST",
        "credential": "MS RD LD CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "1043935",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "LD2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "FROST",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.