Individual provider Active NPI

Katherine Ann Brashears, APRN-NP

  • Pediatric Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1700380268
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
82714 Issued in OK
Practice address
18503 N Portland Ave
Edmond, OK 73012-9149
Phone
(405) 531-4271
Fax
(405) 531-4272
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 82714 OK
Pediatric Nurse Practitioner 363LP0200X 82714 OK Primary

Addresses

Primary practice location

18503 N Portland Ave
Edmond, OK 73012-9149

Mailing address

18503 N Portland Ave
Edmond, OK 73012-9149
Phone (405) 531-4272

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
I20220527001501 OK Practitioner - Nurse Practitioner 7810375151 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82714OKMDSurgical Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Jun 1, 2022 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

18503 N Portland Ave
Edmond, OK 73012
Phone (405) 531-4271

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Interoperability endpoints

  • Direct secure messaging: kbrashears1294080@directc.mercy.net

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1700380268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 N PORTLAND AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129149",
            "telephone_number": "405-531-4272",
            "fax_number": "405-531-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 N PORTLAND AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129149",
            "telephone_number": "405-531-4271",
            "fax_number": "405-531-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASHEARS",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "82714",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "82714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.