Individual provider Active NPI

Kristi Rene Shockley, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1740030261
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
217276 Issued in OK
Practice address
3400 NW Expressway Ste 200
Oklahoma City, OK 73112-4491
Phone
(405) 553-0581
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 217276 OK Primary

Addresses

Primary practice location

3400 NW Expressway Ste 200
Oklahoma City, OK 73112-4491

Mailing address

3400 NW Expressway Ste 200
Oklahoma City, OK 73112-4491

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
I20240605004193 OK Practitioner - Nurse Practitioner 2264974286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Cardiovascular Physicians LLCGroup PAC ID 3577730068, 116 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 300
Oklahoma City, OK 73112-4537
Phone (405) 713-9900

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217276OKMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Cardiovascular Physicians LLC CurrentSince May 1, 2024 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients

Locations

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

3400 NW Expressway St
Ste 200
Oklahoma City, OK 73112
Phone (405) 713-9900

3400 N West Expy
Ste 300
Oklahoma City, OK 73112
Phone (405) 713-9900

3433 NW 56th St
Ste 700
Oklahoma City, OK 73112

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.

Hospital & facility affiliations 5

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": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1740030261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 NW EXPRESSWAY STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124491",
            "telephone_number": "405-553-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "KRISTI",
        "middle_name": "RENE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "217276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.