Individual provider Active NPI

Kimberly Jean Fletcher, DO

  • Obstetrics & Gynecology Physician
  • Moore, OK
National Provider Identifier
1548245129
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3852 Issued in OK
Practice address
2900 S Telephone Rd Ste 200
Moore, OK 73160-2971
Phone
(405) 425-8100
Fax
(405) 425-8119
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 3852 OK Primary

Addresses

Primary practice location

2900 S Telephone Rd Ste 200
Moore, OK 73160-2971

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 425-8100

Other identifiers 1

IdentifierTypeStateIssuer
200062300AMedicaidOK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000140 OK Practitioner - Obstetrics/Gynecology 2062438021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care of Oklahoma, Inc.Group PAC ID 6709771207, 46 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3852OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC Obstetrics & Gynecology CurrentSince Dec 14, 2024 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 14, 2024 Accepting new patients
SSM Health Care of Oklahoma, Inc CurrentSince Apr 1, 2024 Accepting new patients
Integris Ambulatory Care Corporation Obstetrics & Gynecology CurrentSince May 15, 2013 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Moore Medical Center, LLC Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

2900 S Telephone Rd
Ste 200
Moore, OK 73160
Phone (405) 425-8100

1600 SW 119th St
Oklahoma City, OK 73170
Phone (405) 425-8100

535 NW 9th St
Ste 220
Oklahoma City, OK 73102
Phone (405) 272-8498

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

535 NW 9th St
Oklahoma City, OK 73102
Phone (405) 231-2133

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

Interoperability endpoints

  • Direct secure messaging: kfletcher14427@direct.integrisok.com
  • Direct secure messaging: kfletcher508293@direct-ehr-ssmhc.com

Organizations & group practices 7

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1548245129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-425-8100",
            "fax_number": "405-425-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD STE 200",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602971",
            "telephone_number": "405-425-8100",
            "fax_number": "405-425-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200062300A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.