Kellie Renee Swim, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

74972 Issued in OK

Practice address

1500 E Downing St Ste 102
Tahlequah, OK 74464

Phone

(918) 207-0773

Fax

(918) 207-0774

NPI assigned

May 14, 2014

Last updated

Jun 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

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.

• Northeastern Oklahoma Community Health Centers Inc

  dba Hulbert Health Center

  • Federally Qualified Health Center (FQHC)
  • Hulbert, OK
  • NPI 1518070481
  Medicare reassignment NPD
• Northeastern Oklahoma Community Health Centers Inc

  dba Pryor Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Pryor, OK
  • NPI 1669101184
  NPD
• Northeastern Oklahoma Community Health Centers, Inc

  dba NeoHealth

  • Federally Qualified Health Center (FQHC)
  • Tahlequah, OK
  • NPI 1891097077
  NPD
• Muskogee Pediatrics and Family Health Solutions, LLC

  dba Muskogee Pediatrics and Family Health Solutions

  • Pediatrics Physician
  • Muskogee, OK
  • NPI 1316570690
  NPD (past)
• Northeastern Health System

  dba Tahlequah City Hospital

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1003865999
  NPD (past)
• Northeastern Oklahoma Community Health Centers, Inc

  dba NeoHealth

  • Federally Qualified Health Center (FQHC)
  • Westville, OK
  • NPI 1821390402
  NPD (past)
• Wade Pediatrics PC

  • Pediatrics Physician
  • Muskogee, OK
  • NPI 1962475558
  NPD (past)

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1518378371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "HULBERT",
            "state": "OK",
            "postal_code": "744410751",
            "telephone_number": "918-772-3390",
            "fax_number": "918-431-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E DOWNING ST STE 102",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464",
            "telephone_number": "918-207-0773",
            "fax_number": "918-207-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 W Broadway St",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744012138",
            "country_code": "US",
            "telephone_number": "918-683-8442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3505 W Broadway St",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744012138",
            "country_code": "US",
            "telephone_number": "918-683-8442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWIM",
        "first_name": "KELLIE",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "74972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela J Sumter, CADC
• Nicholas T Sundai
• Kyla Marlene Suter, PTA
• Cindy Sutton, PSYCHOMETRIST
• Samuel Quinn Swenson
• Tonya Rae Swim, RD
• Ryan Swindell, OD
• Kaylee Switzer, PA-C
• Farhan Abul Syed, MD
• Sana Syed, M.D.

• Family Nurse Practitioner in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.