Tyler Smith, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

105650 Issued in OK

Practice address

11204 S Cleveland St
Jenks, OK 74037-6202

Phone

(918) 859-4691

NPI assigned

Apr 28, 2016

Last updated

Apr 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, AR, TX3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Green Country Emergency Physicians Group of Tulsa, PLLCGroup PAC ID 0345247052, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Kingfisher, Inc Hospital, Kingfisher, OK, CCN 371313

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Green Country Emergency Physicians Group of Tulsa PLLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1972698553
  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Community Hospital

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Mercy Hospital Kingfisher, Inc

  • Critical Access Hospital
  • Kingfisher, OK
  • NPI 1083048417
  Medicare reassignment NPD
• Mercy Hospital Kingfisher, Inc

  • Diagnostic Radiology Physician
  • Kingfisher, OK
  • NPI 1285064618
  Medicare reassignment NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Medicare reassignment NPD
• Mercy Hospital Watonga Inc

  dba Mercy Hospital Watonga

  • Critical Access Hospital
  • Watonga, OK
  • NPI 1497017529
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Concord Medical Group PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1083630610
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Muscogee Healing and Recovery Center

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Mercy Hospital Logan County, Inc

  dba Mercy Hospital Logan County Crescent Primary Care

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Kingfisher, Inc

  • Critical Access Hospital
  • Kingfisher, OK
  • NPI 1083048417
  Care Compare affiliation

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1538514419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 S CLEVELAND ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740376202",
            "telephone_number": "918-859-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 S CLEVELAND ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740376202",
            "telephone_number": "918-859-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "105650",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "105650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Elise Smith, MS CCC-SLP
• Clarissa Faith Smith
• Deanna Smith, COTA/L
• Dustin W. Smith, D.O.
• Kaitlyn Cheyenne Smith
• Jaina Soodsma
• Trina Souders, SLP
• South Tulsa Chiropractic PC
• South Tulsa Physical Therapy Limited Partnership (Physical Therapy of Jenks)
• South Tulsa Plastic Surgery Center

• Family Nurse Practitioner in Jenks, OK
• Providers in Jenks, 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 Apr 28, 2016; 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.
• 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.