Mary Kathryn O'Connor

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

35435 Issued in OK

Practice address

11729 Hackney LN
Yukon, OK 73099-8130

Phone

(405) 837-9365

NPI assigned

Mar 14, 2015

Last updated

Mar 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Kathryn O'Connor Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1426291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426291200000",
    "number": "1427441401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11729 HACKNEY LN",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998130",
            "telephone_number": "405-837-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11729 HACKNEY LN",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998130",
            "telephone_number": "405-837-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-14",
        "last_updated": "2015-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "35435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "O'CONNOR",
            "middle_name": "KATHRYN",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Family Nurse Practitioner in Yukon, OK
• Providers in Yukon, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.