Individual provider Active NPI

Kyrie Rae Fairweather, APRN, NP-C

  • Family Nurse Practitioner
  • Miami, OK
National Provider Identifier
1760028369
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0106738 Issued in OK
Practice address
10 S Treaty Rd
Miami, OK 74354-5330
Phone
(918) 238-2410
NPI assigned
Nov 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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 R0106738 OK Primary

Addresses

Primary practice location

10 S Treaty Rd
Miami, OK 74354-5330

Mailing address

3011 N Michigan St
Pittsburg, KS 66762-2546
Phone (620) 231-9873

Other practice location 1

7 S 1st St
Wyandotte, OK 74370-2268
Phone (918) 533-8903

Other practice location 2

1102 W 32nd St
Joplin, MO 64804-3503
Phone (417) 347-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210611000691 MO Practitioner - Nurse Practitioner 3577997949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, 385 clinicians

Practice addresses (Care Compare)

1102 W 32 St
Joplin, MO 64804-3503
Phone (417) 347-4570

Hospital & facility affiliations

  • Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137
  • Labette Health Hospital, Parsons, KS, CCN 170120

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0106738OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman-Oak Hill Health System CurrentSince May 31, 2021 Accepting new patients

Locations

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

Organizations & group practices 1

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 3

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": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1760028369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 N MICHIGAN ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622546",
            "telephone_number": "620-231-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S TREATY RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743545330",
            "telephone_number": "918-238-2410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "OK",
            "postal_code": "743702268",
            "country_code": "US",
            "telephone_number": "918-533-8903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 W 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043503",
            "country_code": "US",
            "telephone_number": "417-347-4570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRWEATHER",
        "first_name": "KYRIE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0106738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.