Individual provider Active NPI

Cheryl Ann Feken, APRN,CNP

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1679008809
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36351 Issued in OK
Practice address
817 S Elm PL Ste a
Broken Arrow, OK 74012-5369
Phone
(918) 251-2273
Fax
(918) 258-6446
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 36351 OK Primary

Addresses

Primary practice location

817 S Elm PL Ste a
Broken Arrow, OK 74012-5369

Mailing address

PO Box 659506
Section 4142
San Antonio, TX 78265-9506
Phone (918) 251-2273

Other practice location 1

6048A S Sheridan Rd
Tulsa, OK 74145-9212
Phone (918) 935-3240

Other practice location 2

2811 E 15th St Ste 102
Tulsa, OK 74104-5242
Phone (918) 935-3240

Other identifiers 1

IdentifierTypeStateIssuer
200745280AMedicaidOK

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
I20171120000134 OK Practitioner - Nurse Practitioner 0840556239 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36351OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
National Family Medical Associates, LLC CurrentSince Feb 1, 2023 Accepting new patients
Centennial Health, PC CurrentSince Oct 11, 2021 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

817 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 251-2273

817 S Elm Pl
Ste A
Broken Arrow, OK 74012
Phone (918) 251-2273

225 Lilac Dr
Ste 200
Edmond, OK 73034
Phone (405) 330-7000

701 NE 10th St
Oklahoma City, OK 73104
Phone (405) 232-8003

7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1679008809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 659506",
            "address_2": "SECTION 4142",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782659506",
            "telephone_number": "918-251-2273",
            "fax_number": "405-280-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S ELM PL STE A",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125369",
            "telephone_number": "918-251-2273",
            "fax_number": "918-258-6446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6048A S Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741459212",
            "country_code": "US",
            "telephone_number": "918-935-3240",
            "fax_number": "918-935-3241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2811 E 15th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045242",
            "country_code": "US",
            "telephone_number": "918-935-3240",
            "fax_number": "918-935-3241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEKEN",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "36351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200745280A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.