Individual provider Active NPI

Julie Jarvis, RN

  • Family Nurse Practitioner
  • Sallisaw, OK
National Provider Identifier
1407223605
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
85644 Issued in OK
Practice address
1630 S Kerr Blvd
Sallisaw, OK 74955-7240
Phone
(918) 790-2653
Fax
(918) 790-2763
NPI assigned
Aug 24, 2015
Last updated
May 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 85644 OK Primary
School Registered Nurse 163WS0200X R85644 OK

Addresses

Primary practice location

1630 S Kerr Blvd
Sallisaw, OK 74955-7240

Mailing address

PO Box 179
Stigler, OK 74462-0179
Phone (918) 967-3368

Other practice location 1

106106 State Highway 64B
Muldrow, OK 74948-7343
Phone (918) 427-3808 ext. 5

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
I20200807001785 OK Practitioner - Nurse Practitioner 7416372404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1630 S Kerr Blvd
Sallisaw, OK 74955-7240
Phone (800) 640-9741

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R85644OKMDSchool Registered Nurse
85644OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stigler Health and Wellness Center Inc CurrentSince May 18, 2020 Accepting new patients
Sequoyah County City of Sallisaw Hospital Authority Past Accepting new patients

Locations

1630 S Kerr Blvd
Sallisaw, OK 74955
Phone (918) 790-2653

1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741

Interoperability endpoints

  • Direct secure messaging: jjarvis728121@direct.ochin.org

Organizations & group practices 2

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 3

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1407223605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744620179",
            "telephone_number": "918-967-3368",
            "fax_number": "918-967-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 S KERR BLVD",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749557240",
            "telephone_number": "918-790-2653",
            "fax_number": "918-790-2763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106106 State Highway 64B",
            "address_purpose": "LOCATION",
            "city": "Muldrow",
            "state": "OK",
            "postal_code": "749487343",
            "country_code": "US",
            "telephone_number": "918-427-3808 x5",
            "fax_number": "918-427-4961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "JULIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "85644",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OK",
            "license": "R85644",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

Verify at the official NPI Registry.