Individual provider Active NPI

Thilly-Rae Nelson, APRN

  • Critical Care Medicine Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1487444766
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
200924 Issued in OK
Practice address
3300 NW Expressway
Oklahoma City, OK 73112-4999
Phone
(559) 991-6033
NPI assigned
May 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 200924 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Oklahoma City, OK 73112-4999

Mailing address

208 N Shannon Way
Mustang, OK 73064-2350
Phone (559) 991-6033

Other names 1

  • Tilly Nelson Other name

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
I20251008000400 OK Practitioner - Nurse Practitioner 4183121007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3110 SW 89TH St
Suite 102
Oklahoma City, OK 73159-7919
Phone (405) 703-4950

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200924OKMDPastoral Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Sep 7, 2025 Accepting new patients
Integris Ambulatory Care C Orporation Past Accepting new patients

Locations

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1487444766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N SHANNON WAY",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730642350",
            "telephone_number": "559-991-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124999",
            "telephone_number": "559-991-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "THILLY-RAE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OK",
            "license": "200924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TILLY",
            "last_name": "NELSON",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.