Individual provider Active NPI

Molly Megan Brogdon, APRN

  • Acute Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1609340132
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
105865 Issued in OK
Practice address
6465 S Yale Ave Ste 420
Tulsa, OK 74136-7806
Phone
(918) 502-1700
Fax
(918) 502-1715
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 105865 OK Primary

Addresses

Primary practice location

6465 S Yale Ave Ste 420
Tulsa, OK 74136-7806

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3361
Phone (918) 488-6045

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
I20190228000464 OK Practitioner - Nurse Practitioner 6204175722 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Mar 6, 2019 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6465 S Yale Ave
Ste 420
Tulsa, OK 74136
Phone (918) 502-1700

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: mbrogdon33758@direct.saintfrancis.com

Organizations & group practices 2

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1609340132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6045",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 420",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-502-1700",
            "fax_number": "918-502-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGDON",
        "first_name": "MOLLY",
        "middle_name": "MEGAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "105865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.