Individual provider Active NPI

Robyn Nettles, MD

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1467011015
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34943 Issued in OK
Practice address
2400 NW 36TH St Ste 100
Oklahoma City, OK 73112-7844
Phone
(405) 632-6688
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34943 OK Primary

Addresses

Primary practice location

2400 NW 36TH St Ste 100
Oklahoma City, OK 73112-7844

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other practice location 1

5401 N Portland Ave Ste 500
Oklahoma City, OK 73112-2126
Phone (405) 632-6688

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815001320 OK Practitioner - Family Practice 9931582517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

4000 W Reno Ave
Oklahoma City, OK 73107-6632
Phone (405) 632-6688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. CurrentSince Oct 10, 2022 Accepting new patients
Variety Care, Inc. CurrentSince Oct 10, 2022 Accepting new patients
Variety Care, Inc. Current Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

4000 W Reno Ave
Oklahoma City, OK 73107

5401 N Portland Ave
Ste 500
Oklahoma City, OK 73112
Phone (405) 604-4380

2400 NW 36th St
Ste 100
Oklahoma City, OK 73112
Phone (405) 326-6688

Interoperability endpoints

  • Direct secure messaging: rnettles591383@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1467011015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NW 36TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127844",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 N Portland Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731122126",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTLES",
        "first_name": "ROBYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "34943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.