Individual provider Active NPI

Kasi Melissa Ketcher, APRN-CNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1417403759
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
107495 Issued in OK
Practice address
550 S. Peoria Avenue
Tulsa, OK 74120-3820
Phone
(918) 588-1900
Fax
(918) 582-6405
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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 107495 OK Primary

Addresses

Primary practice location

550 S. Peoria Avenue
Tulsa, OK 74120-3820

Mailing address

550 S. Peoria Avenue
Tulsa, OK 74120-3820
Phone (918) 588-1900

Other names 1

  • Kasi Melissa Ross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170131000610 OK Practitioner - Nurse Practitioner 5294017018 Reassigns benefits to 1 organization
I20250213000393 TX Practitioner - Nurse Practitioner 5294017018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

1800 E Coplin St
Creek Nation Community Hospital
Okemah, OK 74859-4642
Phone (918) 623-1424

Hospital & facility affiliations

  • Council Oak Comprehensive Healthcare Hospital, Tulsa, OK, CCN 370244
  • Muscogee (Creek) Nation Medical Center Hospital, Okmulgee, OK, CCN 370057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107495OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Jan 17, 2025 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 17, 2025 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Indian Health Care Resource Center of Tulsa, Inc. PastSince Sep 13, 2016 Accepting new patients

Locations

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Interoperability endpoints

  • Direct secure messaging: kketcher23440@muscogeecreeknation.direct-ci.com

Organizations & group practices 5

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1417403759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S. PEORIA AVENUE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S. PEORIA AVENUE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHER",
        "first_name": "KASI",
        "middle_name": "MELISSA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "107495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASI",
            "last_name": "ROSS",
            "middle_name": "MELISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.