Individual provider Active NPI

William Karl Thummel, APRN-FNP

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1639830573
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206441 Issued in OK
Practice address
1816 N 12TH St
Broken Arrow, OK 74012-9392
Phone
(918) 724-9239
NPI assigned
Jan 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R0112640 OK
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 206441 OK Primary

Addresses

Primary practice location

1816 N 12TH St
Broken Arrow, OK 74012-9392

Mailing address

1130 E Lansing St
Broken Arrow, OK 74012-2429
Phone (918) 258-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0112640OKMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1639830573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 N 12TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740129392",
            "telephone_number": "918-724-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUMMEL",
        "first_name": "WILLIAM",
        "middle_name": "KARL",
        "name_prefix": "Mr.",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OK",
            "license": "R0112640",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "206441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.