Individual provider Active NPI

Blake Hampton, APRN-CNP

  • Family Nurse Practitioner
  • Durant, OK
National Provider Identifier
1790509966
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
204682 Issued in OK
Practice address
2149 Ed F Davis Rd
Durant, OK 74701-1053
Phone
(580) 931-8180
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 204682 OK Primary

Addresses

Primary practice location

2149 Ed F Davis Rd
Durant, OK 74701-1053

Mailing address

2149 Ed F Davis Rd
Durant, OK 74701-1053
Phone (580) 931-8180

Other names 1

  • Blake Smothers Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241126000102 OK Practitioner - Nurse Practitioner 7618402843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center of Durant PCGroup PAC ID 1850497546, 4 clinicians

Practice addresses (Care Compare)

2149 Ed F Davis Rd
Durant, OK 74701-1053
Phone (580) 931-8180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204682OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center of Durant PC Family CurrentSince Dec 1, 2024 Accepting new patients

Locations

2149 Ed F Davis Rd
Durant, OK 74701
Phone (580) 931-8180

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1790509966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 ED F DAVIS RD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747011053",
            "telephone_number": "580-931-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 ED F DAVIS RD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747011053",
            "telephone_number": "580-931-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "BLAKE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "204682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "SMOTHERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.