Individual provider Active NPI

Ellen Grace Holton

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1497504054
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219698 Issued in OK
Practice address
1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone
(405) 632-6688
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 219698 OK Primary

Addresses

Primary practice location

1025 Straka Ter
Oklahoma City, OK 73139-2544

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

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
I20241024003244 OK Practitioner - Nurse Practitioner 8325571615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone (405) 632-6688

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. Current Accepting new patients
Variety Care, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Variety Care, Inc. CurrentSince Oct 14, 2024 Accepting new patients

Locations

1025 Straka Ter
Oklahoma City, OK 73139
Phone (405) 629-5281

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

Interoperability endpoints

  • Direct secure messaging: eholton744070@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1497504054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 STRAKA TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392544",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "ELLEN",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "219698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.