Jeanette Sue Thomas, FNP – Family Nurse Practitioner

Key facts

NPI: 1851865802
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 50731 (OK)
Practice address: 3330 NW 56TH St Ste 106
Oklahoma City, OK 73112-4426
Phone: (405) 563-8961
Fax: (888) 521-6702
NPI assigned: Jan 13, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Sac & Fox Nation Clinic/Center · Stroud, OK · NPI 1871663203

Medicare reassignment Care Compare group NPD OK
Heartland Travel Health Services LLC Health Maintenance Organization · Oklahoma City, OK · NPI 1013277979

NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

St Anthony Shawnee Hospital Inc General Acute Care Hospital · Shawnee, OK · NPI 1134123193

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2018
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Sac and Fox Nation (14 clinicians)

Practice addresses (Care Compare)

356110 E 930 Rd
Stroud, OK 74079-5184
Phone 91896895313035

Hospital & facility affiliations

SSM Health St Anthony Hospital - Shawnee Hospital · Shawnee, OK · CCN 370149

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20200109000124	OK	Practitioner - Nurse Practitioner	1850726407	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Sac & Fox Nation		Current since Nov 18, 2019	Accepting new patients
Heartland Travel Health Services LLC		Past	Accepting new patients

Locations

356110 E 930 Rd
Stroud, OK 74079
Phone (918) 968-9531

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	50731	OK	Yes

Addresses

Primary practice location

3330 NW 56TH St Ste 106
Oklahoma City, OK 73112-4426

Mailing address

3330 NW 56TH St Ste 106
Oklahoma City, OK 73112-4426
Phone (405) 563-8961

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Family Nurse Practitioner in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.