Individual provider Active NPI

Catina Louise Anderson, A-GNP -C

  • Adult Health Nurse Practitioner
  • Chickasha, OK
National Provider Identifier
1811548894
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R0064950 Issued in OK
Practice address
304 S 29TH St
Chickasha, OK 73018-2501
Phone
(405) 896-8058
Fax
(855) 223-1999
NPI assigned
Sep 22, 2019
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R0064950 OK Primary

Addresses

Primary practice location

304 S 29TH St
Chickasha, OK 73018-2501

Mailing address

50 S B B King Blvd # 100
Memphis, TN 38103-2626
Phone (901) 436-1381

Other identifiers 1

IdentifierTypeStateIssuer
1811548894OtherOKNPI

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
I20230925001409 OK Order and Referring Only - Nurse Practitioner 8921434440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0064950OKMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ms_cande264@landmarkhealth-direct.org

NPI Registry JSON

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

{
    "created_epoch": "1569110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1811548894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S B B KING BLVD # 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032626",
            "telephone_number": "901-436-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S 29TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182501",
            "telephone_number": "405-896-8058",
            "fax_number": "855-223-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CATINA",
        "middle_name": "LOUISE",
        "credential": "A-GNP -C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-22",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "R0064950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811548894",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

Verify at the official NPI Registry.