NR Edmond LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NR EDMOND LLC

Doing business as

Nerve Renewal Edmond

Practice address

3520 S Boulevard Ste 100
Edmond, OK 73013-5413

Phone

(405) 495-7391

Fax

(405) 669-3517

NPI assigned

Nov 3, 2023

Organization subpart

No

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

Authorized official

Name

Timothy Coit Bales, CEO

Title

Ceo

Phone

(405) 953-7221

Specialties & licenses 2

Addresses

Other names 1

• Nerve Renewal Edmond Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheila Diane Moss, FNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1164982104
  Medicare reassignment Care Compare group NPD
• Anne A Munson, M.D.

  • Diagnostic Radiology Physician
  • Edmond, OK
  • NPI 1275584849
  Medicare reassignment Care Compare group NPD
• Becky Annie Raju, FNP-C

  • Family Nurse Practitioner
  • Yukon, OK
  • NPI 1487423216
  Medicare reassignment Care Compare group NPD
• Latrica Friley Dorsey, MSN

  • Gerontology Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1538696083
  Medicare reassignment NPD

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1659144384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161937",
            "telephone_number": "405-953-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 S BOULEVARD STE 100",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135413",
            "telephone_number": "405-495-7391",
            "fax_number": "405-669-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NR EDMOND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "BALES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "COIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-953-7221",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nerve Renewal Edmond",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nerve Renewal Edmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kendall L Novak, RPH
• Martha Nowlin, COTA/L
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• Roderick Nubine
• Yvonne Nuffer, PLPC
• Nugenex Health LLC
• Nugenex Plus Aprn-CNP PLLC
• Alistair Nunamaker

• Physical Medicine & Rehabilitation Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.