Kelly K Kozhulenko, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

205825 Issued in OK

Practice address

2409 NW 172ND Cir
Edmond, OK 73012-0010

Phone

(405) 227-3130

NPI assigned

Oct 25, 2021

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16305/brand/1/csg/1/fhir/r4

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.

• Integrative Medical Solutions PLLC

  dba Integrative Medical Solutions

  • Internal Medicine Physician
  • Edmond, OK
  • NPI 1144471129

  Multi-Specialty

  Medicare reassignment NPD
• The Physicians Group LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1487620381

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1679237887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 NW 172ND CIR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730120010",
            "telephone_number": "405-227-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 NW 172ND CIR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730120010",
            "telephone_number": "405-227-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZHULENKO",
        "first_name": "KELLY",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "205825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kortney Rist-Gill PHD Bcba, LLC
• Tapan Koticha, BDS, MDS
• Jason Kougl
• Reka Kovacs
• David P. Kowalski, LPC, BCBA
• Melissa Diane Krause, LPC
• Michelle Lea Krause, PT/ATC
• Todd Anthony Krehbiel, M.D.
• Jason Kreth
• Kris Watson & Associates Inc (Fine Hearing Care)

• Primary Care Nurse Practitioner in Edmond, OK
• Providers in Edmond, OK by specialty
• Primary Care Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.