Individual provider Active NPI

Stacee Deanne Smiddy, APRN-CNP, IBCLC

  • Women's Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1518201706
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
88833 Issued in OK
Practice address
825 NE 10TH St Ste 3C
Oklahoma City, OK 73104-5417
Phone
(405) 271-9494
Fax
(405) 271-3727
NPI assigned
Nov 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 88833 OK Primary
Lactation Consultant (Registered Nurse) 163WL0100X 88833 OK

Addresses

Primary practice location

825 NE 10TH St Ste 3C
Oklahoma City, OK 73104-5417

Mailing address

250 12TH Ave NE
Norman, OK 73071-5237
Phone (405) 579-2236

Other practice location 1

250 12th Ave NE
Norman, OK 73071-5237
Phone (405) 579-2236

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
I20260604004033 OK Practitioner - Nurse Practitioner 0547731093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1122 NE 13TH St
Oklahoma City, OK 73117-1039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88833OKMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1518201706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 12TH AVE NE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715237",
            "telephone_number": "405-579-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 10TH ST STE 3C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045417",
            "telephone_number": "405-271-9494",
            "fax_number": "405-271-3727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 12th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730715237",
            "country_code": "US",
            "telephone_number": "405-579-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMIDDY",
        "first_name": "STACEE",
        "middle_name": "DEANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-12",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "88833",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OK",
            "license": "88833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.