NPIMap

Individual provider Active NPI

Cheryl Bernice Kroeker, D.O.

  • Family Medicine Physician
  • Chouteau, OK
National Provider Identifier
1730112574
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4306 Issued in OK
Practice address
108 W Main St
Chouteau, OK 74337
Phone
(918) 476-6030
Fax
(918) 476-6038
NPI assigned
Jul 7, 2006
Last updated
May 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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 4306 OK Primary

Addresses

Primary practice location

108 W Main St
Chouteau, OK 74337

Mailing address

451 S Holly St
Siloam Springs, AR 72761-3018
Phone (479) 549-3079

Other identifiers 4

IdentifierTypeStateIssuer
200075950DMedicaidOK
$$$$$$$$$OtherOKOKLAHOMA BCBS
200075950CMedicaidOK
200075950AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061221000074 OK Practitioner - Family PracticePractitioner - Emergency Medicine 2466469879 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

1551 N 9TH St
Broken Arrow, OK 74012-8898
Phone (918) 455-3627

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

609 E Main St
Locust Grove, OK 74352-5191
Phone (918) 479-8060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
South Central Emergency Services PC CurrentSince Mar 1, 2011 Accepting new patients
Kroeker Medical Incorporated Current Accepting new patients
Oklahoma Emergency Physician Partners PLLC Current Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Mar 1, 2024 Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC CurrentSince Jun 1, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients
Mayes County Hma, LLC Past Accepting new patients
Ahs Pryor Hospital, LLC Past Accepting new patients

Locations

105 S Chouteau Ave
Chouteau, OK 74337
Phone (918) 476-6030

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

609 E Main St
Locust Grove, OK 74352
Phone (918) 479-8060

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

1145 S Utica Ave
Ste 110
Tulsa, OK 74104
Phone (918) 579-3825

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 9

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 8

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1730112574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 S HOLLY ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613018",
            "telephone_number": "479-549-3079",
            "fax_number": "479-549-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W MAIN ST",
            "city": "CHOUTEAU",
            "state": "OK",
            "postal_code": "74337",
            "telephone_number": "918-476-6030",
            "fax_number": "918-476-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEKER",
        "first_name": "CHERYL",
        "middle_name": "BERNICE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075950D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA BCBS",
            "identifier": "$$$$$$$$$",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075950C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200075950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chouteau, OK

Sources for this page

Verify at the official NPI Registry.