Individual provider Active NPI

Alexandra Nicole Fifer, APRN

  • Nurse Practitioner
  • Skiatook, OK
National Provider Identifier
1841546637
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
82791 Issued in OK
Practice address
1501 W Rogers Blvd
Suite 1400
Skiatook, OK 74070-3924
Phone
(918) 396-4122
Fax
(918) 403-6301
NPI assigned
Jul 30, 2012
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 82791 OK Primary

Addresses

Primary practice location

1501 W Rogers Blvd
Suite 1400
Skiatook, OK 74070-3924

Mailing address

1501 W Rogers Blvd
Suite 1400
Skiatook, OK 74070-3924
Phone (918) 396-4122

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
I20120813000070 OK Practitioner - Nurse Practitioner 8224284989 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82791OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St John Urgent Care Clinics Inc CurrentSince May 1, 2024 Accepting new patients
St. John Physicians, Inc CurrentSince May 19, 2022 Accepting new patients
Omni Medical Group Inc CurrentSince Nov 25, 2014 Accepting new patients
St. John Physicians, Inc. CurrentSince May 19, 2022 Accepting new patients

Locations

1910 S Falcon Ave
Claremore, OK 74019
Phone (918) 341-1000

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1841546637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W ROGERS BLVD",
            "address_2": "SUITE 1400",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740703924",
            "telephone_number": "918-396-4122",
            "fax_number": "918-403-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W ROGERS BLVD",
            "address_2": "SUITE 1400",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740703924",
            "telephone_number": "918-396-4122",
            "fax_number": "918-403-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFER",
        "first_name": "ALEXANDRA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "82791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skiatook, OK

Sources for this page

Verify at the official NPI Registry.