NPIMap

Organization Active NPI

NKR Enterprises, Aprn-CNP, PLLC

Doing business as Magnolia Clinic

  • Family Nurse Practitioner
  • Shawnee, OK
National Provider Identifier
1639602873
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
86085 Issued in OK
Legal business name
NKR ENTERPRISES, APRN-CNP, PLLC
Doing business as
Magnolia Clinic
Practice address
4409 N Kickapoo Ave
Suite 121
Shawnee, OK 74804-1206
Phone
(405) 249-0459
NPI assigned
Apr 5, 2017
Last updated
Apr 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Katie Luanne Frost, APRN-CNPNPI 1679828693
Title
Aprn-CNP/Owner
Phone
(405) 249-0459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 86085 OK Primary

Addresses

Primary practice location

4409 N Kickapoo Ave
Suite 121
Shawnee, OK 74804-1206

Mailing address

4409 N Kickapoo Ave
Suite 121
Shawnee, OK 74804-1206

Other names 1

  • Magnolia Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170601001258 OK Part B Supplier - Clinic/Group Practice 0547537169 Receives reassigned benefits from 2 practitioners
Practice locations: Shawnee, OK

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1639602873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 N KICKAPOO AVE",
            "address_2": "SUITE 121",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 N KICKAPOO AVE",
            "address_2": "SUITE 121",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041206",
            "telephone_number": "405-249-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NKR ENTERPRISES, APRN-CNP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "LUANNE",
        "authorized_official_title_or_position": "APRN-CNP/OWNER",
        "authorized_official_telephone_number": "405-249-0459",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "86085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.