Individual provider Active NPI

Kristi Diane Keller, APRN, CNP

  • Family Nurse Practitioner
  • Duncan, OK
National Provider Identifier
1710453790
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
80899 Issued in OK
Practice address
3095 Brookwood Ave
Duncan, OK 73533-1355
Phone
(580) 470-9800
NPI assigned
Oct 17, 2018
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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 80899 OK Primary

Addresses

Primary practice location

3095 Brookwood Ave
Duncan, OK 73533-1355

Mailing address

3095 Brookwood Ave
Duncan, OK 73533-1355
Phone (580) 470-9800

Other identifiers 1

IdentifierTypeStateIssuer
80899OtherOKOKLAHOMA BOARD OF NURSING

Other names 1

  • Kristi Diane Mills 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181114001212 OK Practitioner - Nurse Practitioner 6901150796 Reassigns benefits to 2 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
Kimberly M Weaver MD PCGroup PAC ID 0840344131, 4 clinicians

Practice addresses (Care Compare)

3095 Brookwood Ave
Duncan, OK 73533-1355
Phone (580) 470-9800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Kimberly M. Weaver, MD, PC CurrentSince Aug 24, 2024 Accepting new patients
Grady Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1019 15th Ave NW
Ardmore, OK 73401
Phone (580) 226-0100

2100 W Iowa Ave
Ste A
Chickasha, OK 73018
Phone (405) 224-2100

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

512 W Chickasha Ave
Chickasha, OK 73018

910 SW 38th St
Ste B
Lawton, OK 73505
Phone (405) 355-7443

1125 N Porter Ave
Ste 305
Norman, OK 73071

2921 Adams Rd
Ste 111
Norman, OK 73069

Interoperability endpoints

  • Direct secure messaging: kkeller@direct.gradymem.org

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, 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": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1710453790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 BROOKWOOD AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331355",
            "telephone_number": "580-470-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 BROOKWOOD AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331355",
            "telephone_number": "580-470-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KRISTI",
        "middle_name": "DIANE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "80899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA BOARD OF NURSING",
            "identifier": "80899",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "MILLS",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.