Individual provider Active NPI

Valerie Suzanne Kautz, APRN

  • Family Nurse Practitioner
  • Checotah, OK
National Provider Identifier
1740735570
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
81153 Issued in OK
Practice address
212 W Spaulding St
Checotah, OK 74426-2452
Phone
(918) 473-0048
Fax
(918) 473-4547
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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 81153 OK Primary

Addresses

Primary practice location

212 W Spaulding St
Checotah, OK 74426-2452

Mailing address

1505 E Main St
Stigler, OK 74462-2913
Phone (918) 967-3368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230627000314 TX Practitioner - Nurse Practitioner 2668751850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Potawatomi NationGroup PAC ID 3375511488, 35 clinicians

Practice addresses (Care Compare)

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone (405) 273-5236

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Potawatomi Nation CurrentSince May 2, 2023 Accepting new patients
Citizen Potawatomi Nation Current Accepting new patients
Citizen Potawatomi Nation CurrentSince May 2, 2023 Accepting new patients

Locations

781 Grand Casino Blvd
Shawnee, OK 74804
Phone (405) 964-4025

2307 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 273-5236

Interoperability endpoints

  • FHIR API: https://epicproxy.et1447.epichosted.com/APIProxyPRD/api/FHIR/R4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1740735570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622913",
            "telephone_number": "918-967-3368",
            "fax_number": "918-967-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W SPAULDING ST",
            "city": "CHECOTAH",
            "state": "OK",
            "postal_code": "744262452",
            "telephone_number": "918-473-0048",
            "fax_number": "918-473-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUTZ",
        "first_name": "VALERIE",
        "middle_name": "SUZANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "81153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Checotah, OK

Sources for this page

Verify at the official NPI Registry.