Active NPI
Elizabeth A Nettles, D.O.
- Internal Medicine Physician
- Muskogee, OK
National Provider Identifier
1831287432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 3721
- Practice address
- 1011 Honor Heights Dr
Muskogee, OK 74401-1318 - Phone
- (918) 683-3261
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3721 | OK | Primary |
Addresses
Primary practice location
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Mailing address
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Phone (918) 683-3261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3721 | OK | MD | Clinical Social Worker |
Interoperability endpoints
- elizabeth.nettles.1@20767.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831287432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 HONOR HEIGHTS DR",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744011318",
"telephone_number": "918-683-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 HONOR HEIGHTS DR",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744011318",
"telephone_number": "918-683-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETTLES",
"first_name": "ELIZABETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "3721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.