Individual provider Active NPI

Kellie J Ward

  • Gerontology Registered Nurse
  • Oklahoma City, OK
National Provider Identifier
1386270312
Registry record updated Mar 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
82856 Issued in OK
Practice address
225 SW 35TH St
Oklahoma City, OK 73109-6807
Phone
(405) 631-7444
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 82856 OK Primary

Addresses

Primary practice location

225 SW 35TH St
Oklahoma City, OK 73109-6807

Mailing address

2513 W Park PL
Oklahoma City, OK 73107-5431
Phone (405) 558-1835

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
82856OKMDGerontology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584835200000",
    "number": "1386270312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 W PARK PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731075431",
            "telephone_number": "405-558-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SW 35TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731096807",
            "telephone_number": "405-631-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KELLIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2020-03-22",
        "certification_date": "2020-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "OK",
            "license": "82856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 22, 2020; 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.