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Individual provider Active NPI

Jessica Deppen, APRN

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1659774131
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
91728 Issued in OK
Practice address
5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone
(405) 557-1200
Fax
(405) 557-1977
NPI assigned
Sep 29, 2014
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 91728 OK Primary

Addresses

Primary practice location

5721 NW 132ND St
Oklahoma City, OK 73142-4437

Mailing address

5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 557-1200

Other practice location 1

1201 Magnolia Ct Ste 105
Moore, OK 73160-1433
Phone (405) 497-1872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151102002151 OK Practitioner - Nurse Practitioner 3779624317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Term Care Specialists, IncGroup PAC ID 3476550740, 37 clinicians

Practice addresses (Care Compare)

1515 Kingsridge Dr
Oklahoma City, OK 73170-4475
Phone (405) 692-8700

3233 NW 10 St
GLC NW
Oklahoma City, OK 73107-5203
Phone (405) 943-8366

400 Sw79Th St
Crystal Place
Oklahoma City, OK 73139-8120
Phone (405) 616-1980

5721 NW 132ND St
Oklahoma City, OK 73142-4437
Phone (405) 557-1200

615 W Blueridge Dr
Brookdale MWC
Midwest City, OK 73110-1241
Phone (405) 741-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91728OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Term Care Specialists, Inc CurrentSince Dec 1, 2017 Accepting new patients
Careconnectmd Oklahoma PC CurrentSince Jan 1, 2025 Accepting new patients
Shiloh Imaging Center LLC Current Accepting new patients
Value Based Long Term Care J PC CurrentSince May 13, 2025 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

101 Park Ave
Ste 1300
Oklahoma City, OK 73102
Phone (405) 689-9820

3233 NW 10th St
Oklahoma City, OK 73107
Phone (405) 943-8366

5721 NW 132nd St
Oklahoma City, OK 73142
Phone (405) 557-1200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1659774131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 NW 132ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731424437",
            "telephone_number": "405-557-1200",
            "fax_number": "405-557-1977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Magnolia Ct Ste 105",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "OK",
            "postal_code": "731601433",
            "country_code": "US",
            "telephone_number": "405-497-1872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPPEN",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "91728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.