Individual provider Active NPI

Janet Trogdon, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1487816104
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
77215 Issued in OK
Practice address
1620 E 12TH St
Tulsa, OK 74120-5407
Phone
(918) 582-2131
Fax
(918) 588-8803
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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 77215 OK Primary

Addresses

Primary practice location

1620 E 12TH St
Tulsa, OK 74120-5407

Mailing address

17387 E 470 Rd
Claremore, OK 74017-0998
Phone (918) 697-4528

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
I20140922002586 OK Practitioner - Nurse Practitioner 4587883624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Peteryne D. Miller, M.D. LLCGroup PAC ID 9537492616, 2 clinicians

Practice addresses (Care Compare)

4870 S Lewis Ave
Suite 205
Tulsa, OK 74105-5153
Phone (918) 863-2910

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Peteryne D. Miller, M.D. LLC CurrentSince Jan 28, 2021 Accepting new patients
Bart Trentham, PLLC CurrentSince Jan 28, 2021 Accepting new patients

Locations

4870 S Lewis Ave
Ste 205
Tulsa, OK 74105
Phone (918) 745-9233

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1487816104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17387 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740170998",
            "telephone_number": "918-697-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205407",
            "telephone_number": "918-582-2131",
            "fax_number": "918-588-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROGDON",
        "first_name": "JANET",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "77215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.