Individual provider Active NPI

Kendra Jo Peters, APRN-CNP

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1699331371
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
91043 Issued in OK
Practice address
3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone
(405) 949-3349
NPI assigned
May 17, 2019
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 91043 OK
Family Nurse Practitioner 363LF0000X 91043 OK
Acute Care Nurse Practitioner 363LA2100X 91043 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Oklahoma City, OK 73112-4418

Mailing address

5300 N Independence Ave Ste 280
Oklahoma City, OK 73112-5555

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
I20190812003358 OK Practitioner - Nurse Practitioner 0446587505 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

429 W Elm
Hobart, OK 73651-1615
Phone (580) 726-1900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91043OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jun 27, 2019 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jun 27, 2019 Accepting new patients
Kiowa County Hospital Authority CurrentSince May 2, 2023 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Nov 1, 2022 Accepting new patients
Integris Cardiovascular Physicians LLC CurrentSince Nov 15, 2022 Accepting new patients
Kiowa County Hospital Authority Past Accepting new patients

Locations

429 W Elm St
Hobart, OK 73651
Phone (580) 726-1900

825 NE 10th St
#4G
Oklahoma City, OK 73104
Phone (405) 271-5789

3433 NW 56th St
Oklahoma City, OK 73112
Phone (405) 947-3341

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

3433 NW 56th St
Ste 660
Oklahoma City, OK 73112
Phone (405) 947-3341

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

Interoperability endpoints

  • Direct secure messaging: kpeters215581@direct.integrisok.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1699331371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124418",
            "telephone_number": "405-949-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KENDRA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OK",
            "license": "91043",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "91043",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "91043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.