Jackeline Vanessa Pickelsimer, DNP, APRN-CNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

111011 Issued in OK

Practice address

1025 Straka Ter
Oklahoma City, OK 73139-2544

Phone

(405) 632-6688

NPI assigned

Sep 30, 2020

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpickelsimer376636@direct.ochin.org

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.

• Variety Care, Inc.

  dba Variety Care, Straka

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1780697813
  Medicare reassignment Care Compare group NPD
• Variety Care, Inc.

  dba Variety Care Mobile Women's Health

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1942045455
  NPD
• Variety Care, Inc.

  dba Variety Care Lafayette

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1982939526
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Integris South Oklahoma City Hospital Corporation

  dba Integris Southwest Breast Center

  • Mammography Clinic/Center
  • Oklahoma City, OK
  • NPI 1336155779

  Hospital

  Care Compare affiliation
• Integris South Oklahoma City Hospital Corporation

  dba Integris Jim Thorpe Inpatient Rehabilitation

  • Rehabilitation Hospital Unit
  • Oklahoma City, OK
  • NPI 1336252717
  Care Compare affiliation
• Integris South Oklahoma City Hospital Corporation

  dba Integris Health Southwest Medical Center

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1457372625
  Care Compare affiliation

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1629685946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 STRAKA TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392544",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKELSIMER",
        "first_name": "JACKELINE",
        "middle_name": "VANESSA",
        "credential": "DNP, APRN-CNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "111011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Picchione
• Lindsey Piccirillo
• Bradley Piccolo, P.T.
• Gisselle C Pichardo, DO
• Jason David Pickard, O.D.
• James Allan Pickens, M.D.
• Jiavonna Pickens
• Lawanda Stover Pickens, RNC, MS, NNP
• Patricia Carlene Pickens
• Melanie Ryan Pickering, CM II

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.