Active NPI
Kasi Melissa Ketcher, APRN-CNP
- Family Nurse Practitioner
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 107495
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
- Muscogee (Creek) Nation Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107495 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Nation Hospital & Clinics | Current | Accepting new patients | |
| Creek Nation Hospital & Clinics | Current | 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. | Past | 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
- 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.
-
- Clinic/Center
- Muskogee, OK
- NPI 1366593923
-
- General Acute Care Hospital
- Okmulgee, OK
- NPI 1033511480
-
- Clinic/Center
- Muskogee, OK
- NPI 1922873611
-
- Pharmacy
- Tulsa, OK
- NPI 1457447609
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Hospital
- Okmulgee, OK
- NPI 1376979955
-
- General Acute Care Hospital
- Okmulgee, OK
- NPI 1902236573
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.