Active NPI
Megan Elizabeth Black, APRN, C-NP
- Nurse Practitioner
- Broken Bow, OK
National Provider Identifier
1568820140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 100330
- Practice address
- 110 W 1St St
Broken Bow, OK 74728 - Phone
- (580) 584-3099
- Fax
- (580) 584-3097
- NPI assigned
- Feb 10, 2016
- Last updated
- Aug 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 100330 | OK | Primary |
Addresses
Primary practice location
110 W 1St St
Broken Bow, OK 74728
Mailing address
110 W 1St St
Broken Bow, OK 74728-3902
Phone (580) 584-3099
Other practice location 1
1201 Health Center Pkwy
Yukon, OK 73099-6381
Phone (405) 951-2277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200636630A | Medicaid | OK |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
110 W 1St St
Broken Bow, OK 74728-3902
Phone (580) 584-3099
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100330 | OK | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black Oak Clinic LLC | Current | Accepting new patients | |
| Essent PRMC LP | Past | Accepting new patients | |
| McCurtain Memorial Medical Management, Inc. | Past | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
110 W 1st St
Broken Bow, OK 74728
Phone (580) 584-3099
Interoperability endpoints
- black.megan.1@17168.direct.athenahealth.com
- https://api.platform.athenahealth.com/17168/brand/1/csg/1/fhir/r4
Organizations & group practices 4
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.
-
- Clinic/Center
- Broken Bow, OK
- NPI 1366954661
-
dba McCurtain Memorial Hospital
- Critical Access Hospital
- Idabel, OK
- NPI 1063900975
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
-
dba Paris Regional Medical Center
- General Acute Care Hospital
- Paris, TX
- NPI 1063411767
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mays Home Care Broken Bow
- Home Health Agency
- Idabel, OK
- NPI 1275023756
-
dba McCurtain Memorial Hospital
- Critical Access Hospital
- Idabel, OK
- NPI 1063900975
-
dba Paris Regional Medical Center
- General Acute Care Hospital
- Paris, TX
- NPI 1063411767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533600000000",
"number": "1568820140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 W 1ST ST",
"city": "BROKEN BOW",
"state": "OK",
"postal_code": "747283902",
"telephone_number": "580-584-3099",
"fax_number": "844-716-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 W 1ST ST",
"city": "BROKEN BOW",
"state": "OK",
"postal_code": "74728",
"telephone_number": "580-584-3099",
"fax_number": "580-584-3097"
}
],
"practiceLocations": [
{
"address_1": "1201 Health Center Pkwy",
"address_purpose": "LOCATION",
"city": "Yukon",
"state": "OK",
"postal_code": "730996381",
"country_code": "US",
"telephone_number": "405-951-2277",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACK",
"first_name": "MEGAN",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "APRN, C-NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-10",
"last_updated": "2018-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "100330",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200636630A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broken Bow, OK
- Erin Janine Bartlett, DDS
- Battles Broken Bow Family Clinic, LLC (Broken Bow Family Clinic LLC)
- Leslie Orr Battles, CNP
- BBHR Opco, LLC (Broken Bow Health and Rehab)
- Black Oak Clinic LLC
- Tonya Joy Boles, PAC
- Jade Chantelle Box, BHRS
- Brighter Heights Oklahoma, LLC (Brighter Heights Oklahoma)
- Broken Bow Dentistry PLLC (Broken Bow Dentistry)
- Broken Bow Health and Rehab LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.