Individual provider Active NPI

Kelli Ann Anderson, APRN, CNP

  • Adult Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1447924980
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
201707 Issued in OK
Practice address
8803 S 101St East Ave
Tulsa, OK 74133-5726
Phone
(918) 579-3270
NPI assigned
Aug 8, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 201707 OK Primary

Addresses

Primary practice location

8803 S 101St East Ave
Tulsa, OK 74133-5726

Mailing address

127 W 116TH St
Jenks, OK 74037-3679
Phone (918) 605-5242

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
I20210908000424 OK Practitioner - Nurse Practitioner 9234535857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

8803 S 101St E Ave
Suite 390
Tulsa, OK 74133-7549
Phone (918) 392-5424

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC CurrentSince Aug 29, 2021 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Aug 29, 2021 Accepting new patients

Locations

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

1245 S Utica Ave
Ste 302
Tulsa, OK 74104
Phone (918) 382-2560

8803 S 101st East Ave
Tulsa, OK 74133
Phone (918) 250-2033

8803 S 101st East Ave
Ste 390
Tulsa, OK 74133
Phone (918) 294-8000

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
  • Direct secure messaging: kmeyer110631@ahs.direct-ci.com

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 5

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": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1447924980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W 116TH ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373679",
            "telephone_number": "918-605-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 S 101ST EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335726",
            "telephone_number": "918-579-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "201707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.