Kelly White, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

96367 Issued in OK

Practice address

11911 S Memorial Dr
Bixby, OK 74008-2030

Phone

(918) 943-3790

Fax

(918) 943-3793

NPI assigned

Dec 5, 2019

Last updated

Jun 8, 2023By 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

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prophylaxis Healthcare LLCGroup PAC ID 3072784289, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prophylaxis Healthcare LLC

  dba Axis HealthCare

  • Multi-Specialty Clinic/Center
  • Bixby, OK
  • NPI 1538453923
  Medicare reassignment Care Compare group NPD
• Comprehensive Rehab Consultants PLLC

  dba Comprehensive Rehab Consultants LLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  Family, OK

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OK

  Medicare reassignment NPD
• Prophylaxis Healthcare LLC

  dba Axis Behavioral Health

  • Community/Behavioral Health Agency
  • Bixby, OK
  • NPI 1285438317
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1437796711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740080334",
            "telephone_number": "918-970-4719",
            "fax_number": "918-970-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082030",
            "telephone_number": "918-943-3790",
            "fax_number": "918-943-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "96367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasee Way, CCC-SLP
• Eric Paul Welch
• Brandon Wells, PT, DPT
• Brent Alan West, DC
• Gloria L. White
• Shanon Williams-Walker
• Terri Evalene Williamson, DPH
• Judith D Wilson, RN
• Monica Jane Winford, APRN, NP- C
• Clayton Minor Woodard

• Family Nurse Practitioner in Bixby, OK
• Providers in Bixby, 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 Jun 8, 2023; 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.

Verify at the official NPI Registry.