Dianne Genene Tupper, R.N., OPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1148 Issued in OK

Practice address

12301 N Western Ave Ste 101
Oklahoma City, OK 73114-8017

Phone

(405) 757-8338

Fax

(405) 715-7179

NPI assigned

Jul 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Dianne Genene Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Prairie Gardens Medical LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1669080891
  NPD Authorized official
• Prairie Gardens Medical LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1689280067
  NPD Authorized official
• Tupper Orthopedics PLLC

  • Orthopaedic Surgery Physician
  • Oklahoma City, OK
  • NPI 1821231929
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1740578103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 LARY LN",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730446542",
            "telephone_number": "405-742-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 N WESTERN AVE STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731148017",
            "telephone_number": "405-757-8338",
            "fax_number": "405-715-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPPER",
        "first_name": "DIANNE",
        "middle_name": "GENENE",
        "name_prefix": "Mrs.",
        "credential": "R.N., OPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "OK",
            "license": "R0083080",
            "primary": false
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "OK",
            "license": "83080",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1148",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE",
            "last_name": "JACKSON",
            "middle_name": "GENENE",
            "prefix": "MS.",
            "credential": "RN, OPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nay Thi Tun, M.D.,
• Trenee L Tunick, LCSW
• Melisa Tunley
• Kimberly R Tunnell, LMSW
• Tupper Orthopedics PLLC
• Joel Scott Tupper, MD
• Caroline Ann Turan
• Adam Turbeville
• Meredith Turbeville, DDS
• Alden W Turci

• Medical Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.