Individual provider Active NPI

Tracy Sue Ogden, NP

  • Nurse Practitioner
  • Ponca City, OK
National Provider Identifier
1861725103
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
93682 Issued in OK
Practice address
1908 N 14TH St Ste 205
Ponca City, OK 74601-2039
Phone
(580) 718-4532
NPI assigned
Sep 17, 2009
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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 93682 OK Primary

Addresses

Primary practice location

1908 N 14TH St Ste 205
Ponca City, OK 74601-2039

Mailing address

1908 N 14TH St Ste 205
Ponca City, OK 74601-2039
Phone (580) 718-4532

Other identifiers 1

IdentifierTypeStateIssuer
200270850AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ogden-tracy.ogden.1@4696.direct.athenahealth.com

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
I20100302000541 OK Practitioner - Nurse Practitioner 5193860104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

105 E Grand Ave
Tonkawa, OK 74653-3503
Phone (580) 308-3080

1323 NW 6TH Ave
Stillwater, OK 74074-4306
Phone (405) 372-1480

1323 W 6TH Ave
Kansas City, MO 74074-4306

706 S 13TH St
Suite B
Blackwell, OK 74631-3705
Phone (580) 363-9354

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2022 Accepting new patients
Nes Oklahoma, Inc. CurrentSince Dec 15, 2019 Accepting new patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2022 Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Physicians Past Accepting new patients

Locations

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

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

518 E Lakeview Rd
Stillwater, OK 74075
Phone (405) 533-8990

105 E Grand Ave
Tonkawa, OK 74653
Phone (580) 308-3080

Interoperability endpoints

  • Direct secure messaging: ogden-tracy.ogden.1@4696.direct.athenahealth.com
  • Direct secure messaging: tracy.ogden.1@16109.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1861725103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 205",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-718-4532",
            "fax_number": "580-540-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N 14TH ST STE 205",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012039",
            "telephone_number": "580-718-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGDEN",
        "first_name": "TRACY",
        "middle_name": "SUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "93682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200270850A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ogden-tracy.ogden.1@4696.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1908 N 14th St Ste 205",
            "city": "Ponca City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "746012039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

Verify at the official NPI Registry.