Individual provider Active NPI

Jessica Lynn Avila, APRN-CNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1508478439
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78874 Issued in OK
Practice address
8921 S. Mingo Rd
Tulsa, OK 74133
Phone
(918) 252-8000
NPI assigned
Aug 21, 2020
Last updated
May 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 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 78874 OK Primary

Addresses

Primary practice location

8921 S. Mingo Rd
Tulsa, OK 74133

Mailing address

8921 S. Mingo Rd
Tulsa, OK 74133
Phone (918) 252-8000

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
I20210825001899 OK Practitioner - Nurse Practitioner 4385049691

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78874OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Home Health, Inc Past Accepting new patients

Organizations & group practices 1

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": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1508478439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 S. MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-252-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 S. MINGO RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-252-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "78874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.