Individual provider Active NPI

Janice Burkybile, DNP, APRN-CNP

  • Family Nurse Practitioner
  • Glenpool, OK
National Provider Identifier
1548041403
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214889 Issued in OK
Practice address
14748 S Yukon Ave
Glenpool, OK 74033-4333
Phone
(918) 852-4416
NPI assigned
Oct 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0109708 OK
Family Nurse Practitioner 363LF0000X 214889 OK Primary

Addresses

Primary practice location

14748 S Yukon Ave
Glenpool, OK 74033-4333

Mailing address

14748 S Yukon Ave
Glenpool, OK 74033-4333
Phone (918) 852-4416

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
I20260430000113 OK Practitioner - Nurse Practitioner 9133696875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14748 S Yukon Ave
Glenpool, OK 74033-4333

PO Box
Suite 334
Bixby, OK 74008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0109708OKMDRegistered Nurse
214889OKMDFamily Nurse Practitioner

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": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1548041403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14748 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740334333",
            "telephone_number": "918-852-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14748 S YUKON AVE",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740334333",
            "telephone_number": "918-852-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKYBILE",
        "first_name": "JANICE",
        "credential": "DNP, APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0109708",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "214889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenpool, OK

Sources for this page

Verify at the official NPI Registry.