Individual provider Active NPI

Carol Ann Demond, ARNP

  • Family Nurse Practitioner
  • Miami, OK
National Provider Identifier
1386826113
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
69259 Issued in OK
Practice address
7600 S Highway 69a
Miami, OK 74354-1016
Phone
(918) 542-1655
Fax
(918) 332-4395
NPI assigned
Dec 4, 2007
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 69259 OK Primary

Addresses

Primary practice location

7600 S Highway 69a
Miami, OK 74354-1016

Mailing address

7600 S Highway 69a
Miami, OK 74354-1016
Phone (918) 542-1655

Other identifiers 3

IdentifierTypeStateIssuer
200468380CMedicaidOK
100710600GMedicaidOK
200186820AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080508000791 TX Practitioner - Nurse Practitioner 1153400643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Tribal Health SystemGroup PAC ID 7911893854, 20 clinicians

Practice addresses (Care Compare)

7600 S Hwy 69a
Miami, OK 74354-1016
Phone (918) 542-1655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69259OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Tribal Health System CurrentSince Mar 3, 2008 Accepting new patients

Locations

7600 S Highway 69A
Miami, OK 74354
Phone (918) 542-1655

Organizations & group practices 1

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.

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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1386826113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 S HIGHWAY 69A",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541016",
            "telephone_number": "918-542-1655",
            "fax_number": "918-332-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 S HIGHWAY 69A",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541016",
            "telephone_number": "918-542-1655",
            "fax_number": "918-332-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOND",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "69259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468380C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100710600G",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200186820A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.