Individual provider Active NPI

Nancy A. Jefferson, N.P.

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1619965662
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0059141 Issued in OK
Practice address
1717A S Utica Ave
Tulsa, OK 74104-5344
Phone
(918) 748-1300
Fax
(918) 748-1303
NPI assigned
Oct 12, 2005
Last updated
Feb 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0059141 OK Primary

Addresses

Primary practice location

1717A S Utica Ave
Tulsa, OK 74104-5344

Mailing address

2915 E 97TH PL
Apt 1201
Tulsa, OK 74137-7309
Phone (918) 296-9477

Other identifiers 1

IdentifierTypeStateIssuer
200039750AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100303000745 TX Practitioner - Nurse Practitioner 1254398399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0059141OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Jan 1, 2010 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Jan 1, 2010 Accepting new patients
St John Urgent Care Clinics Inc Past Accepting new patients
Sterling Emergency Services of Oklahoma, Inc. Past Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Interoperability endpoints

  • Direct secure messaging: njefferson19223@choctawnation.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1619965662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E 97TH PL",
            "address_2": "APT 1201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377309",
            "telephone_number": "918-296-9477",
            "fax_number": "918-748-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717A S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045344",
            "telephone_number": "918-748-1300",
            "fax_number": "918-748-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "NANCY",
        "middle_name": "A.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0059141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200039750A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.