Individual provider Active NPI

Patti Denise Wheaton, MSN, ARNP

  • Family Nurse Practitioner
  • Jenks, OK
National Provider Identifier
1669569000
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0049248 Issued in OK
Practice address
1239 W Main St
Jenks, OK 74037-2311
Phone
(918) 291-0004
Fax
(918) 296-3911
NPI assigned
Oct 6, 2006
Last updated
Jan 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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 R0049248 OK Primary
Women's Health Nurse Practitioner 363LW0102X R0049248 OK

Addresses

Primary practice location

1239 W Main St
Jenks, OK 74037-2311

Mailing address

1239 W Main St
Jenks, OK 74037-2311
Phone (918) 291-0004

Other identifiers 1

IdentifierTypeStateIssuer
200003840MedicaidOK

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
I20150716000360 OK Practitioner - Nurse Practitioner 2769795004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0049248OKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beair Medical Group, PLLC CurrentSince Aug 15, 2018 Accepting new patients
Obstetrical & Gynecological Assoc of Tulsa Past Accepting new patients
Faith Family Clinic, PC Family Past Accepting new patients

Locations

5018 E 68th St
Ste 200
Tulsa, OK 74136
Phone (918) 492-1001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBEFCD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1669569000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-291-0004",
            "fax_number": "918-296-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-291-0004",
            "fax_number": "918-296-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATON",
        "first_name": "PATTI",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "MSN, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0049248",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R0049248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200003840",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenks, OK

Sources for this page

Verify at the official NPI Registry.