Beverly Aiello, APRN - CNP

Individual provider Active NPI Family Nurse Practitioner · Thomas, OK

NPI 1760915946 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1760915946
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
105895 (OK)
Practice address
100 S 2ND St
Thomas, OK 73669-8201
Phone
(580) 341-0870
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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 1

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roger Mills County Hospital Authority (7 clinicians)

Practice addresses (Care Compare)

P O Box
Suite 490
Cheyenne, OK 73628-0490

Hospital & facility affiliations

  • Roger Mills Memorial Hospital Hospital · Cheyenne, OK · CCN 371303
  • Roger Mills Memorial Hospital Nursing home · CCN 37Z303

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170628001256 OK Practitioner - Nurse Practitioner 2264701671 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0105895OKMDRegistered Nurse
201601668RNORMDRegistered Nurse
105895OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC Current
since Jun 19, 2019
Accepting new patients
Williams Medical Group Practice, LLC Current
since Jun 19, 2019
Accepting new patients
Roger Mills County Hospital Authority Past Accepting new patients
Roger Mills County Hospital Authority Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Roger Mills County Hospital Authority Past Accepting new patients

Locations

411 W Grand Ave
Chickasha, OK 73018
Phone (405) 224-0053

411 W 3rd St
Elk City, OK 73644
Phone (580) 303-9293

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

1303 N Washington St
Weatherford, OK 73096
Phone (580) 772-2820

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201601668RN OR
Registered Nurse 163W00000X R0105895 OK
Family Nurse Practitioner 363LF0000X 105895 OK Yes

Addresses

Primary practice location

100 S 2ND St
Thomas, OK 73669-8201

Mailing address

100 S 2ND St
Thomas, OK 73669-8201
Phone (580) 341-0870

Other practice location 1

PO Box 490
Cheyenne, OK 73628-0490
Phone (580) 497-3333

Other identifiers

IdentifierTypeStateIssuer
105895OtherOKAPRN-CNP
R0105895OtherOKOKLAHOMA RN LICENSE

Other providers in Thomas, OK

All providers in Thomas, OK · Family Nurse Practitioner in Oklahoma

Sources for this page

Verify at the official NPI Registry.