Active NPI
Glenda Gene Cross, APRN-CNP
- Family Nurse Practitioner
- Kingston, OK
National Provider Identifier
1649412263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R0067070
- Practice address
- 21 N Main St
Kingston, OK 73439-6562 - Phone
- (580) 564-7885
- Fax
- (580) 564-7902
- NPI assigned
- Mar 27, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 67070 | OK | |
| Family Nurse Practitioner | 363LF0000X | R0067070 | OK | Primary |
Addresses
Primary practice location
21 N Main St
Kingston, OK 73439-6562
Mailing address
610 E 24TH
Tishomingo, OK 73460
Phone (580) 371-2343
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100824000132 | OK | Practitioner - Nurse Practitioner | 0941324255 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 387-0509
Hospital & facility affiliations
- Texoma Medical Center
- Alliancehealth Durant
- Mercy Hospital Ardmore, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67070 | OK | MD | Family Nurse Practitioner |
| R0067070 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Center of Southern Oklahoma Inc | Current | Accepting new patients | |
| Family Health Center of Southern Oklahoma Inc | Current | Accepting new patients | |
| Family Health Center of Southern Oklahoma Inc | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
610 E 24th St
Tishomingo, OK 73460
Phone (580) 371-2343
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73380
- glenda.cross@fhcso.directbygreenway.com
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Tishomingo, OK
- NPI 1598803942
OK
-
- Federally Qualified Health Center (FQHC)
- Coalgate, OK
- NPI 1174830665
-
- Federally Qualified Health Center (FQHC)
- Milburn, OK
- NPI 1669321824
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1649412263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 24TH",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "73460",
"telephone_number": "580-371-2343",
"fax_number": "580-371-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 N MAIN ST",
"city": "KINGSTON",
"state": "OK",
"postal_code": "734396562",
"telephone_number": "580-564-7885",
"fax_number": "580-564-7902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSS",
"first_name": "GLENDA",
"middle_name": "GENE",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-27",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "67070",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0067070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingston, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.