Kavanah Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KAVANAH MEDICAL LLC

Practice address

11560 N 135TH East Ave
Owasso, OK 74055-5755

Phone

(918) 553-1188

Fax

(918) 553-1189

NPI assigned

Dec 4, 2019

Organization subpart

No

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

Authorized official

Name

Kristina M Doolittle, APRN-CNPNPI 1306353552

Title

Owner / Nurse Practitioner

Phone

(918) 553-1188

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rx Health & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20421/brand/1/csg/1/fhir/r4

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina Doolittle

  • Family Nurse Practitioner
  • Bartlesville, OK
  • NPI 1306353552
  Medicare reassignment Care Compare group NPD Authorized official
• Alejandra Gabriela Duncan, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Owasso, OK
  • NPI 1295478360
  Medicare reassignment Care Compare group NPD
• Rebekah Ann Fairchild, CNP

  • Acute Care Nurse Practitioner
  • Bartlesville, OK
  • NPI 1386317915
  Medicare reassignment Care Compare group NPD
• Leah Rachel Loyd, RDN/LD

  • Registered Dietitian
  • Bartlesville, OK
  • NPI 1104325844
  Medicare reassignment Care Compare group NPD
• Shannon Cherie Nanaeto, MS, APRN-CNP

  • Primary Care Nurse Practitioner
  • Catoosa, OK
  • NPI 1730963596
  Medicare reassignment Care Compare group NPD
• Tracy Stuckey, CNP

  • Family Nurse Practitioner
  • Bartlesville, OK
  • NPI 1861093379
  Medicare reassignment Care Compare group NPD
• Jayme Marie Taylor, APRN, FNP-BC

  • Primary Care Nurse Practitioner
  • Bartlesville, OK
  • NPI 1912333154
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1548807993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740550844",
            "telephone_number": "918-553-1188",
            "fax_number": "918-553-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 N 135TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555755",
            "telephone_number": "918-553-1188",
            "fax_number": "918-553-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAVANAH MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "DOOLITTLE",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / NURSE PRACTITIONER",
        "authorized_official_telephone_number": "918-553-1188",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA NURSING BOARD",
            "identifier": "95706",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rx Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Joyce, PTA
• Danya Julson, D.O.
• Jessica Edem Kanwhen, PHARM.D.
• Sonja Kapchinsky
• Seth Kardasopoulos
• Jessica Erin Kay, LCSW
• Melinda Keith, PT
• Michelle Lynn Kellam, COTA/L
• Jason Warren Keller, DPH.
• Amylyn Kelley

• Family Medicine Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.