Individual provider Active NPI

Kimberly McNabb, CRNA

  • Certified Registered Nurse Anesthetist
  • Tulsa, OK
National Provider Identifier
1497128193
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
97429 Issued in OK
Practice address
1923 S Utica Ave
Davis Tower 200
Tulsa, OK 74104-6520
Phone
(918) 744-0123
NPI assigned
Nov 4, 2015
Last updated
May 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 97429 OK Primary

Addresses

Primary practice location

1923 S Utica Ave
Davis Tower 200
Tulsa, OK 74104-6520

Mailing address

8058 Vintage Trace Dr
Claremore, OK 74019-7511
Phone (918) 304-9098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208000635 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870897184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
97429OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care of Oklahoma, Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Northstar Anesthesia of Oklahoma, PLLC CurrentSince Aug 23, 2022 Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1923 S Utica Ave
#200
Tulsa, OK 74104
Phone (918) 744-0123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1497128193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8058 VINTAGE TRACE DR",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740197511",
            "telephone_number": "918-304-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S UTICA AVE",
            "address_2": "DAVIS TOWER 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741046520",
            "telephone_number": "918-744-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "KIMBERLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "97429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.