Individual provider Active NPI

Glenda Gene Cross, APRN-CNP

  • Family Nurse Practitioner
  • Kingston, OK
National Provider Identifier
1649412263
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0067070 Issued in OK
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

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
Family Health Center of Southern Oklahoma IncGroup PAC ID 4284537457, 34 clinicians

Practice addresses (Care Compare)

610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 387-0509

Hospital & facility affiliations

  • Texoma Medical Center Hospital, Denison, TX, CCN 450324
  • Alliancehealth Durant Hospital, Durant, OK, CCN 370014
  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67070OKMDFamily Nurse Practitioner
R0067070OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center of Southern Oklahoma Inc CurrentSince Jun 3, 2010 Accepting new patients
Family Health Center of Southern Oklahoma Inc Current Accepting new patients
Family Health Center of Southern Oklahoma Inc CurrentSince Jun 3, 2010 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

610 E 24th St
Tishomingo, OK 73460
Phone (580) 371-2343

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73380
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.