Individual provider Active NPI

Nicole Ida Harris, APRN, CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1699276402
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105925 Issued in OK
Practice address
15103 N Macarthur Blvd
Oklahoma City, OK 73132
Phone
(866) 389-2727
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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 105925 OK Primary

Addresses

Primary practice location

15103 N Macarthur Blvd
Oklahoma City, OK 73132

Mailing address

15103 N Macarthur Blvd
Oklahoma City, OK 73132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180427000897 OK Practitioner - Nurse Practitioner 2264796275 Reassigns benefits to 3 organizations
I20240313003348 NC Practitioner - Nurse Practitioner 2264796275 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105925OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NR Midwest City LLC CurrentSince Dec 28, 2023 Accepting new patients
Venvisor Health of NC CurrentSince Jan 29, 2024 Accepting new patients
The Physicians Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Best Physicians at Home, Inc CurrentSince May 23, 2022 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

3908 N Peniel Ave
Ste 450
Bethany, OK 73008

1920 E 1st St
Ste F
Chandler, OK 74834
Phone (405) 255-2155

8121 National Ave
Ste 105
Midwest City, OK 73110
Phone (405) 694-4042

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21335/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1699276402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15103 N MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15103 N MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73132",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "NICOLE",
        "middle_name": "IDA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "105925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.