Individual provider Active NPI

Kelly Dawn Stemm, APRN-CNP

  • Women's Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1477789923
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R93630 Issued in OK
Practice address
4444 E 41St St
Tulsa, OK 74135-2527
Phone
(918) 619-4400
Fax
(918) 619-4216
NPI assigned
Jun 10, 2009
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R93630 OK Primary

Addresses

Primary practice location

4444 E 41St St
Tulsa, OK 74135-2527

Mailing address

PO Box 268838
Oklahoma City, OK 73126-8838
Phone (918) 619-4200

Other practice location 1

2235 E 61st St Ste B
Tulsa, OK 74136-0102
Phone (539) 479-9802

Other identifiers 1

IdentifierTypeStateIssuer
200249650AMedicaidOK

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
I20131105001342 OK Practitioner - Nurse Practitioner 9234282104 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R93630OKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma Ou Physicians Tulsa CurrentSince Feb 15, 2022 Accepting new patients
Archwell Health Professional Services of Oklahoma, LLC CurrentSince Aug 1, 2024 Accepting new patients
Christian Counseling Center of Tulsa Past Accepting new patients

Locations

1111 S Saint Louis Ave
Tulsa, OK 74120
Phone (918) 619-4600

2235 E 61st St
Ste B
Tulsa, OK 74136
Phone (539) 476-9802

3138 S Garnett Rd
Tulsa, OK 74146
Phone (918) 203-7005

4444 E 41st St
Tulsa, OK 74135

4444 E 41st St
Ste B
Tulsa, OK 74135
Phone (918) 619-4801

8005 E 106th St
Tulsa, OK 74133
Phone (918) 591-5711

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: kelly.stemm@214522098548740.direct.elationemr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1477789923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268838",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268838",
            "telephone_number": "918-619-4200",
            "fax_number": "918-619-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 E 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352527",
            "telephone_number": "918-619-4400",
            "fax_number": "918-619-4216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 E 61st St Ste B",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741360102",
            "country_code": "US",
            "telephone_number": "539-479-9802",
            "fax_number": "539-476-9804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEMM",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R93630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200249650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.