Individual provider Active NPI

Antonia M Pratt-Reid, ARNP

  • Family Nurse Practitioner
  • Yukon, OK
National Provider Identifier
1477595635
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0050603 Issued in OK
Practice address
11109 Surrey Hills Blvd
Yukon, OK 73099-8155
Phone
(405) 373-2400
Fax
(405) 373-4400
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0050603 OK Primary

Addresses

Primary practice location

11109 Surrey Hills Blvd
Yukon, OK 73099-8155

Mailing address

PO Box 660
Piedmont, OK 73078-0660
Phone (405) 373-2400

Other identifiers 2

IdentifierTypeStateIssuer
100203760CMedicaidOK
P00027716OtherOKRR MEDICARE

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
I20060707000138 OK Practitioner - Nurse Practitioner 9335136266 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Health Care and Minor Emergency Clinic IncGroup PAC ID 8729075650, 3 clinicians

Practice addresses (Care Compare)

11109 Surrey Hills Blvd
Yukon, OK 73099-8155
Phone (405) 373-2400

6102 NW 63Rd St
B
Oklahoma City, OK 73132-7526
Phone (405) 373-2400

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care & Minor Emergency Clinic Inc CurrentSince Oct 10, 2002 Accepting new patients
Neighborhood Family Clinic & Minor CurrentSince Mar 1, 2006 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Health Services Inc. Past Accepting new patients
Neighborhood Family Clinic and Minor Emergency Services Past Accepting new patients
Oklahoma Sleep Institute Clinic Okc LLC Osi Clinic Family PastSince Jun 1, 2009 Accepting new patients

Locations

6102 NW 63rd St
Ste B
Oklahoma City, OK 73132
Phone (405) 373-2400

6102 NW 63rd St
Ste A
Oklahoma City, OK 73132
Phone (405) 373-2400

6102 NW 63rd St
#B
Oklahoma City, OK 73132
Phone (405) 373-2400

11109 Surrey Hills Blvd
Yukon, OK 73099
Phone (405) 373-2400

12328 N Mustang Rd
Yukon, OK 73099
Phone (405) 373-2400

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1477595635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730780660",
            "telephone_number": "405-373-2400",
            "fax_number": "405-373-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 SURREY HILLS BLVD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998155",
            "telephone_number": "405-373-2400",
            "fax_number": "405-373-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT-REID",
        "first_name": "ANTONIA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0050603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100203760C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00027716",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.