Individual provider Active NPI

Tammy Diane Vermeulen, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1598095143
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
77115 Issued in OK
Practice address
4221 S Western Ave Ste 4005
Oklahoma City, OK 73109-3436
Phone
(405) 644-5040
Fax
(405) 644-5039
NPI assigned
Jan 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 77115 OK Primary
Family Nurse Practitioner 363LF0000X 77115 OK

Addresses

Primary practice location

4221 S Western Ave Ste 4005
Oklahoma City, OK 73109-3436

Mailing address

4221 S Western Ave Ste 4005
Oklahoma City, OK 73109-3436
Phone (405) 644-5040

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
I20100330000008 OK Practitioner - Nurse Practitioner 2860528858 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

4221 S Western Ave
4005 Integris ENT Southwest
Oklahoma City, OK 73109-3436
Phone (405) 644-5190

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
77115OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Oklahoma LLC Family CurrentSince Oct 2, 2011 Accepting new patients
Midwest Hospital Medicine Associates PC Family CurrentSince Nov 1, 2021 Accepting new patients
Summit Medical Center Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

1040 SW 19th St
Moore, OK 73160
Phone (405) 794-3001

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Interoperability endpoints

  • Direct secure messaging: tvermeulen14519@direct.integrisok.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1598095143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE STE 4005",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093436",
            "telephone_number": "405-644-5040",
            "fax_number": "405-644-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 S WESTERN AVE STE 4005",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093436",
            "telephone_number": "405-644-5040",
            "fax_number": "405-644-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMEULEN",
        "first_name": "TAMMY",
        "middle_name": "DIANE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "77115",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "77115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.