Individual provider Active NPI

Jessica Ann Brewer, APRN

  • Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1609139153
Registry record updated Dec 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
89364 Issued in OK
Practice address
2907 S Boston CT
Tulsa, OK 74114-5214
Phone
(580) 277-5551
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 89364 OK Primary

Addresses

Primary practice location

2907 S Boston CT
Tulsa, OK 74114-5214

Mailing address

2907 S Boston CT
Tulsa, OK 74114-5214
Phone (580) 277-5551

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
I20120724000480 OK Practitioner - Nurse Practitioner 5092971838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4142 S Harvard Ave
Suite D3
Tulsa, OK 74135-2617
Phone (918) 716-9717

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellness LLC Nurse Practitioner CurrentSince Jul 1, 2022 Accepting new patients
Tulsa Perinatal Evaluation Center PastSince Nov 16, 2015 Accepting new patients
Morton Comprehensive Health Services, Inc PastSince Feb 18, 2014 Accepting new patients

Locations

4146 S Harvard Ave
#F6
Tulsa, OK 74135

4142 S Harvard Ave
Ste D3
Tulsa, OK 74135
Phone (918) 486-9977

4146 S Harvard Ave
Ste F6
Tulsa, OK 74135
Phone (918) 716-9717

Interoperability endpoints

  • Direct secure messaging: jessica.brewer.1@20602.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20602/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576281600000",
    "number": "1609139153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 S BOSTON CT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741145214",
            "telephone_number": "580-277-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 S BOSTON CT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741145214",
            "telephone_number": "580-277-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2019-12-14",
        "certification_date": "2019-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "89364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.