Individual provider Active NPI

Whitney Michelle Simmons, APRN

  • Gerontology Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1679180699
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
200705 Issued in OK
Practice address
14000 N Portland Ave Ste 204
Oklahoma City, OK 73134-4025
Phone
(405) 548-4848
Fax
(833) 470-1448
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 109792 OK
Gerontology Nurse Practitioner 363LG0600X 200705 OK Primary

Addresses

Primary practice location

14000 N Portland Ave Ste 204
Oklahoma City, OK 73134-4025

Mailing address

14000 N Portland Ave Ste 204
Oklahoma City, OK 73134-4025
Phone (405) 548-4848

Other practice location 1

4150 S Harvard Ave Ste G1
Tulsa, OK 74135-2614
Phone (918) 863-2731

Other identifiers 1

IdentifierTypeStateIssuer
SSNMedicaidOK

Other names 1

  • Whitney Michelle Calley Former name

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
I20220107001876 OK Practitioner - Nurse Practitioner 9638561335

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6912 S Quentin St
Suite 50
Centennial, CO 80112-4531

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109792OKMDRegistered Nurse
200705OKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Infusion Solutions LLC CurrentSince Dec 14, 2021 Accepting new patients
Mosaic Infusion Solutions LLC Current Accepting new patients
Mosaic Infusion Solutions LLC CurrentSince Dec 14, 2021 Accepting new patients

Locations

6912 S Quentin St
Ste 50
Englewood, CO 80112

14000 N Portland Ave
Ste 204
Oklahoma City, OK 73134
Phone (405) 548-4848

4150 S Harvard Ave
Ste G1
Tulsa, OK 74135
Phone (918) 863-2731

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1679180699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 N PORTLAND AVE STE 204",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731344025",
            "telephone_number": "405-548-4848",
            "fax_number": "833-470-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 N PORTLAND AVE STE 204",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731344025",
            "telephone_number": "405-548-4848",
            "fax_number": "833-470-1448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 S Harvard Ave Ste G1",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741352614",
            "country_code": "US",
            "telephone_number": "918-863-2731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "WHITNEY",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "109792",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "200705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SSN",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITNEY",
            "last_name": "CALLEY",
            "middle_name": "MICHELLE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.