Nicole L Fetters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1102 Issued in OK

Practice address

900 NE 10TH St
Oklahoma City, OK 73104-5420

Phone

(405) 271-4311

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

No

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Resource Management LLCGroup PAC ID 4082753918, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nicole.fetterspac.p10@direct.nextcare.nextgenshare.com
• Direct secure messaging: nicole.fetterspac.p8@direct.nextcare.nextgenshare.com

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.

• Medical Resource Management, LLC

  dba Access Medical Center

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1104056365
  Medicare reassignment Care Compare group
• Tulsa Emergency Medical Center Inc

  dba Access Medical Center

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1063479087
  Medicare reassignment

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1679656920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI 236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045420",
            "telephone_number": "405-271-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael Ferris, M.D.
• Kelsey B Ferris
• Ferrous Health Medical Group PA (Iron Health OK)
• Ashlie Michelle Fessenden
• Aaron Joseph Kaufman Fest, MD
• Fhcokc, Inc
• Steven Michael Fick, D.D.S.
• Fidelis One LLC
• Kylee Marie Fiebiger
• Grant Field, DC

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.