Individual provider Active NPI

Jennifer Christina McDonald, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ardmore, OK
National Provider Identifier
1639048028
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
226243 Issued in OK
Practice address
1908 12TH Ave NW Ste E
Ardmore, OK 73401-1255
Phone
(580) 226-3055
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 226243 OK Primary

Addresses

Primary practice location

1908 12TH Ave NW Ste E
Ardmore, OK 73401-1255

Mailing address

1908 12TH Ave NW Ste E
Ardmore, OK 73401-1255
Phone (580) 226-3055

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
I20260106002022 OK Practitioner - Nurse Practitioner 7315433703 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
Group practices
Elmbrook Clinical Services, LLCGroup PAC ID 3870949548, 5 clinicians

Practice addresses (Care Compare)

1908 12TH Ave NW
Suite E
Ardmore, OK 73401-1255
Phone 5802263055209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226243OKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elmbrook Clinical Services LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1908 12th Ave NW
Ste E
Ardmore, OK 73401
Phone (580) 226-3055

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": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1639048028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 12TH AVE NW STE E",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011255",
            "telephone_number": "580-226-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 12TH AVE NW STE E",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011255",
            "telephone_number": "580-226-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "226243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.