Individual provider Active NPI

Jolene Traum, NP

  • Family Nurse Practitioner
  • Moore, OK
National Provider Identifier
1851750277
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
82876 Issued in OK
Practice address
2900 S Telephone Rd
Moore, OK 73160-2968
Phone
(405) 237-7500
NPI assigned
Feb 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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 82876 OK Primary

Addresses

Primary practice location

2900 S Telephone Rd
Moore, OK 73160-2968

Mailing address

2900 S Telephone Rd
Moore, OK 73160-2968

Other names 1

  • Jolene Miller 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
I20160705000810 OK Practitioner - Nurse Practitioner 1951693324 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC CurrentSince Jul 1, 2019 Accepting new patients
Emergency Services of Oklahoma PC CurrentSince Jun 1, 2016 Accepting new patients
Oklahoma Emergency Services PC CurrentSince Mar 5, 2017 Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Discovery Medical Diagnostic Group, LLC PastSince Aug 20, 2018 Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Integris Canadian Valley Hospital Past Accepting new patients

Locations

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1851750277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968",
            "telephone_number": "405-237-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUM",
        "first_name": "JOLENE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "82876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLENE",
            "last_name": "MILLER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.