Individual provider Active NPI

Jacqueline D Hash, FNP-BC

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1871054858
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209161 Issued in OK
Practice address
4812 S 109TH East Ave Ste 101
Tulsa, OK 74146-5829
Phone
(918) 748-3103
NPI assigned
Mar 30, 2019
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95011247 CA
Family Nurse Practitioner 363LF0000X 209161 OK Primary

Addresses

Primary practice location

4812 S 109TH East Ave Ste 101
Tulsa, OK 74146-5829

Mailing address

5220 Belfort Rd Ste 130
Jacksonville, FL 32256-6018
Phone (619) 997-4786

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
I20220910000636 OK Practitioner - Nurse Practitioner 3072856152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paradigm Wound Specialists LLCGroup PAC ID 4284086828, 12 clinicians
Healogics Specialty Physicians of Oklahoma PLLCGroup PAC ID 2264758705, 20 clinicians

Practice addresses (Care Compare)

3105 E Skelly Dr
Suite 310
Tulsa, OK 74105-6371
Phone (918) 954-1083

4812 S 109TH E Ave
Suite 101
Tulsa, OK 74146-5829
Phone (918) 748-3103

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95011247CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Oklahoma, PLLC CurrentSince Oct 31, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Aug 29, 2022 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Aug 29, 2022 Accepting new patients
Nightingale Clinical Care, PC CurrentSince Oct 1, 2020 Accepting new patients
St John Medical Center Inc Past Accepting new patients
Total Renal Care Inc Past Accepting new patients

Locations

902 Bear Mountain Blvd
Arvin, CA 93203
Phone (209) 543-1720

2438 N Ponderosa Dr
Ste C101
Camarillo, CA 93010
Phone (559) 664-9252

4445 Riverside Dr
Chino, CA 91710
Phone (760) 202-3491

510 E North Way
Dinuba, CA 93618
Phone (209) 473-2294

11690 San Pablo Ave
El Cerrito, CA 94530

501 E Almond Ave
Madera, CA 93637
Phone (559) 664-9252

3001 Health Care Way
Ste 102
Modesto, CA 95356
Phone (559) 664-9255

78030 Wildcat Dr
Ste 101
Palm Desert, CA 92211
Phone (908) 845-4494

320 James Way
Ste 100
Pismo Beach, CA 93449
Phone (209) 827-3973

4361 Latham St
Ste 270
Riverside, CA 92501
Phone (559) 285-5946

3 Rossi Cir
Unit A
Salinas, CA 93907
Phone (760) 371-7506

9850 Carmel Mountain Rd
San Diego, CA 92129
Phone (805) 764-0171

555 W Benjamin Holt Dr
Ste 200
Stockton, CA 95207
Phone (661) 725-1370

30730 Russell Ranch Rd
Ste A
Westlake Village, CA 91362
Phone (805) 643-7549

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

222 SE Debell Ave
Bartlesville, OK 74006
Phone (918) 335-1811

3500 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-1555

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

2716 W Gore Blvd
Ste C
Lawton, OK 73505
Phone (580) 357-3280

550 W Shawnee St
Muskogee, OK 74401
Phone (908) 910-5186

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

949 E Taft Ave
Sapulpa, OK 74066
Phone (918) 224-6079

4812 S 109th East Ave
Ste 101
Tulsa, OK 74146
Phone (918) 748-3103

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1871054858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566018",
            "telephone_number": "619-997-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 S 109TH EAST AVE STE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465829",
            "telephone_number": "918-748-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASH",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-30",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011247",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "209161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.