Organization Active NPI

Byrd Health Care LLC

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1861895385
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
92389 Issued in OK
Legal business name
BYRD HEALTH CARE LLC
Practice address
5622 N Portland Ave
#102
Oklahoma City, OK 73112-2096
Phone
(405) 917-7590
Fax
(405) 917-7595
NPI assigned
Sep 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Authorized official

Name
Jalyn Denise Byrd, APRN-CNPNPI 1346655180
Title
Family Nurse Practitioner
Phone
(405) 250-0017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 92389 OK Primary

Addresses

Primary practice location

5622 N Portland Ave
#102
Oklahoma City, OK 73112-2096

Mailing address

5622 N Portland Ave
#102
Oklahoma City, OK 73112-2096
Phone (405) 917-7590

Other identifiers 1

IdentifierTypeStateIssuer
200545340AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150122000950 OK Part B Supplier - Clinic/Group Practice 1759605744 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2170871Byrd Health Care LLC5622 N Portland Ave, Ste 102, Oklahoma City, OK 73112Certificate of waiverAug 20, 2027

National Provider Directory

National Provider Directory

Locations

5622 N Portland Ave
Ste 102
Oklahoma City, OK 73112
Phone (405) 917-7590

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1861895385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 N PORTLAND AVE",
            "address_2": "#102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122096",
            "telephone_number": "405-917-7590",
            "fax_number": "405-917-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5622 N PORTLAND AVE",
            "address_2": "#102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122096",
            "telephone_number": "405-917-7590",
            "fax_number": "405-917-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRD HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "JALYN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "405-250-0017",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "92389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200545340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.