NPIMap

Individual provider Active NPI

Kenda L Dean, ARNP

  • Family Nurse Practitioner
  • Grandfield, OK
National Provider Identifier
1801081658
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
75098 Issued in OK
Practice address
117 S Bridge Blvd
Grandfield, OK 73546
Phone
(580) 560-5715
Fax
(580) 560-5735
NPI assigned
Sep 13, 2007
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP133894 TX
Family Nurse Practitioner 363LF0000X 75098 OK Primary
General Practice Registered Nurse 163WG0000X R0075098 OK

Addresses

Primary practice location

117 S Bridge Blvd
Grandfield, OK 73546

Mailing address

PO Box 475
Grandfield, OK 73546-0475
Phone (580) 560-5715

Other identifiers 1

IdentifierTypeStateIssuer
200125730AMedicaidOK

Other names 1

  • Kenda L Nichols Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000867 OK Practitioner - Nurse Practitioner 5799856068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 S Bridge Blvd
Grandfield, OK 73546-9564
Phone (580) 560-5715

PO Box
Suite 475
Grandfield, OK 73546

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0075098OKMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Surgical Affiliates, LLC CurrentSince Jan 1, 2017 Accepting new patients
Bridging Family Healthcare, LLC Family CurrentSince Mar 1, 2022 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients

Locations

117 S BRG Blvd
Grandfield, OK 73546
Phone (580) 560-5715

117 S BRG Blvd
Grandfield, OK 73546
Phone (580) 560-5715

5606 SW Lee Blvd
Ste 205
Lawton, OK 73505
Phone (580) 531-6465

5610 SW Lee Blvd
Lawton, OK 73505
Phone (580) 353-8600

Interoperability endpoints

  • Direct secure messaging: bfh@bfh.azalea.phimailbox.com
  • FHIR API: https://api.platform.athenahealth.com/1821/brand/1/csg/22/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25527/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bridging Family HealthcareGrandfield, OK, CCN 373912 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 23, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 7

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1801081658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "GRANDFIELD",
            "state": "OK",
            "postal_code": "735460475",
            "telephone_number": "580-560-5715",
            "fax_number": "580-560-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S BRIDGE BLVD",
            "city": "GRANDFIELD",
            "state": "OK",
            "postal_code": "73546",
            "telephone_number": "580-560-5715",
            "fax_number": "580-560-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KENDA",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133894",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "75098",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OK",
            "license": "R0075098",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDA",
            "last_name": "NICHOLS",
            "middle_name": "L",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grandfield, OK

Sources for this page

Verify at the official NPI Registry.