Individual provider Active NPI

Kelli Lovelace, M.D.

  • Dermatology Physician
  • Tulsa, OK
National Provider Identifier
1629117528
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
23483 Issued in OK
Practice address
2121 E 21St St
Tulsa, OK 74114-1409
Phone
(918) 749-2261
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 23483 OK Primary

Addresses

Primary practice location

2121 E 21St St
Tulsa, OK 74114-1409

Mailing address

PO Box 52588
Tulsa, OK 74152-0588
Phone (918) 749-2261

Other identifiers 4

IdentifierTypeStateIssuer
200124080AMedicaidOK
P00444180OtherRAILROAD MEDICARE
7255935OtherAETNA HMO
23483OtherOKMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822000257 OK Practitioner - Dermatology 1557453685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Oklahoma College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Dermatology Clinic IncGroup PAC ID 7719079839, 8 clinicians

Practice addresses (Care Compare)

2121 E 21St St
Tulsa, OK 74114-1409
Phone (918) 749-2261

Merit-based Incentive Payment System (MIPS)

Final score
93.35 of 100Reported as individual
Quality
87.91
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions2130
Removal or shaving of skin growth113
Skin biopsy372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23483OKMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Dermatology Clinic Inc Dermatology CurrentSince Jul 1, 2007 Accepting new patients

Locations

1222 N Florence Ave
Claremore, OK 74017
Phone (918) 342-2528

1222 N Florence Ave
Ste C
Claremore, OK 74017
Phone (918) 341-5200

2121 E 21st St
Tulsa, OK 74114
Phone (918) 749-2261

Interoperability endpoints

  • Direct secure messaging: kelli.lovelace@direct.stjohnhealthsystem.com

Organizations & group practices 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1629117528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52588",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741520588",
            "telephone_number": "918-749-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E 21ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141409",
            "telephone_number": "918-749-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "KELLI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "23483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200124080A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00444180",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "7255935",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "23483",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.