Individual provider Active NPI

Krista Nicole Havener

  • Specialist
  • El Reno, OK
National Provider Identifier
1760670293
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
200 N Choctaw
Suite 140
El Reno, OK 73036-2624
Phone
(405) 262-3209
Fax
(405) 262-1331
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

200 N Choctaw
Suite 140
El Reno, OK 73036-2624

Mailing address

200 N Choctaw Ave
Suite 140
El Reno, OK 73036-2624
Phone (405) 262-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Red Rock Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1760670293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N CHOCTAW AVE",
            "address_2": "SUITE 140",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730362624",
            "telephone_number": "405-262-3203",
            "fax_number": "405-262-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N CHOCTAW",
            "address_2": "SUITE 140",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730362624",
            "telephone_number": "405-262-3209",
            "fax_number": "405-262-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENER",
        "first_name": "KRISTA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Reno, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.