Individual provider Active NPI

Tasha Kay Clewell

  • Family Nurse Practitioner
  • Watonga, OK
National Provider Identifier
1619704475
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223996 Issued in OK
Practice address
407 N Clarence Nash Blvd
Watonga, OK 73772-3636
Phone
(580) 623-2233
Fax
(580) 623-2232
NPI assigned
Sep 16, 2024
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0129874 OK
Family Nurse Practitioner 363LF0000X 223996 OK Primary

Addresses

Primary practice location

407 N Clarence Nash Blvd
Watonga, OK 73772-3636

Mailing address

407 N Clarence Nash Blvd
Watonga, OK 73772-3636
Phone (580) 623-2233

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
I20250920000388 OK Practitioner - Nurse Practitioner 2567966633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

407 N Clarence Nash Blvd
Watonga, OK 73772-3636
Phone (580) 623-4954

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0129874OKMDRegistered Nurse
223996OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Sep 1, 2025 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

407 N Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-2233

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1619704475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N CLARENCE NASH BLVD",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737723636",
            "telephone_number": "580-623-2233",
            "fax_number": "580-623-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N CLARENCE NASH BLVD",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737723636",
            "telephone_number": "580-623-2233",
            "fax_number": "580-623-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEWELL",
        "first_name": "TASHA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0129874",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "223996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watonga, OK

Sources for this page

Verify at the official NPI Registry.