Individual provider Active NPI

Rebekah Ariana Fraley, DO

  • Family Medicine Physician
  • Ardmore, OK
National Provider Identifier
1700528510
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8200 Issued in OK
Practice address
1104 Walnut Dr
Ardmore, OK 73401-2353
Phone
(580) 226-0543
Fax
(580) 226-2284
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8200 OK Primary

Addresses

Primary practice location

1104 Walnut Dr
Ardmore, OK 73401-2353

Mailing address

20 12TH Ave NW
Ardmore, OK 73401-5722
Phone (580) 223-3411

Other names 1

  • Miss Rebekah Ariana Roe Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250627001305 OK Practitioner - Family Practice 5496136061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Shepherd Community Clinic, Inc.Group PAC ID 4284936337, 19 clinicians

Practice addresses (Care Compare)

1104 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 223-3411

Hospital & facility affiliations

  • Ideal Home Care, L.P. Home health agency, Ardmore, OK, CCN 377678
  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Community Clinic, Inc. CurrentSince Jun 30, 2025 Accepting new patients

Locations

1104 Walnut Dr
Ardmore, OK 73401
Phone 5802233411308

20 12th Ave NW
Ardmore, OK 73401
Phone (580) 223-3411

1116 Walnut Dr
Ardmore, OK 73401
Phone (580) 226-0543

2401 N Commerce St
Ardmore, OK 73401
Phone (580) 226-0410

Interoperability endpoints

  • Direct secure messaging: rebekah.fraley.1@21725.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1700528510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "REBEKAH",
        "middle_name": "ARIANA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "8200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "ROE",
            "middle_name": "ARIANA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.