Jessica Rae Provost, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

93861 Issued in OK

Practice address

1919 E Memorial Rd
Oklahoma City, OK 73131-1253

Phone

(405) 341-7009

Fax

(405) 330-1811

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jprovost252677@directc.mercy.net

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment Care Compare group NPD
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  Care Compare affiliation

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1659724144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311253",
            "telephone_number": "405-341-7009",
            "fax_number": "405-330-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311253",
            "telephone_number": "405-341-7009",
            "fax_number": "405-330-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "93861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Family Practice, PLLC
• Providence Home Care LLC
• Provincial Home Care (Community Hospice of Oklahoma)
• Provision Cares Proton Center Okc, LLC
• Provision Medical Supplies, Inc.
• Maria Gabriella Prudhomme, NP
• Geoffrey Allen Pruett, D.M.D.
• Pruett'S Food, Inc. (Buy for Less Pharmacy (Pruett's Lake Hefner))
• Aubrey Leigh Pruitt
• Garland Pruitt

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.

Verify at the official NPI Registry.