Individual provider Active NPI

Erin Molly Robertson, APRNCNP

  • Primary Care Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1639641202
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
85964 Issued in OK
Practice address
1717 S Boulder Ave Ste 700
Tulsa, OK 74119-4845
Phone
(918) 295-7506
Fax
(918) 600-2639
NPI assigned
Dec 20, 2018
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 85964 OK Primary
Registered Nurse 163W00000X 85964 OK

Addresses

Primary practice location

1717 S Boulder Ave Ste 700
Tulsa, OK 74119-4845

Mailing address

1717 S Boulder Ave Ste 700
Tulsa, OK 74119-4845
Phone (918) 295-7506

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
I20190401000450 OK Practitioner - Nurse Practitioner 5597006502 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85964OKMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Medical Group Inc CurrentSince Apr 15, 2019 Accepting new patients
Ahs Oklahoma Physician Group LLC CurrentSince Sep 1, 2019 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 3

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": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1639641202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S BOULDER AVE STE 700",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194845",
            "telephone_number": "918-295-7506",
            "fax_number": "918-600-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S BOULDER AVE STE 700",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194845",
            "telephone_number": "918-295-7506",
            "fax_number": "918-600-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "ERIN",
        "middle_name": "MOLLY",
        "name_prefix": "Mrs.",
        "credential": "APRNCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "85964",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "85964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.