Charlysa Diana Gatlin Castillo, APRN CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

105641 Issued in OK

Practice address

905 Colony Dr
Ada, OK 74820-2329

Phone

(580) 436-5111

NPI assigned

Jun 3, 2017

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Charlysa Diana Gatlin Brady Former name

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Oklahoma Family Medical Center IncGroup PAC ID 9931189685, shared by 15 NPIs, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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.

• Central Oklahoma Family Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Konawa, OK
  • NPI 1831291293
  Medicare reassignment NPD
• Emergency Services of Oklahoma PC

  • Emergency Medicine Physician
  • Norman, OK
  • NPI 1215249891
  Medicare reassignment NPD
• Central Oklahoma Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ada, OK
  • NPI 1770399008
  NPD
• Central Oklahoma Family Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ada, OK
  • NPI 1144997693
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  dba Mercy Hospital Ada

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1760910772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD STE 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602969",
            "telephone_number": "405-237-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 COLONY DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202329",
            "telephone_number": "580-436-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "CHARLYSA",
        "middle_name": "DIANA GATLIN",
        "credential": "APRN CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-03",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "105641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLYSA",
            "last_name": "BRADY",
            "middle_name": "DIANA GATLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Dawn Carter
• Penni Cartlidge, APRN-CNP
• G. Frank Cartmell, M. D.
• Tamera Casady
• Robert W Cashman, OD
• Pamela Marie Catalano, ARNP
• Sharell Clydean Caton, LPC, LADC
• Mindy Caudill
• Central Oklahoma Family Medical Center Inc
• Central Oklahoma Family Medical Center Inc

• Family Nurse Practitioner in Ada, OK
• Providers in Ada, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.