Active NPI
Adrienne Marie Jantz, APRN
- Nurse Practitioner
- Oklahoma City, OK
National Provider Identifier
1871175166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 206107
- Practice address
- 2807 N Walker Ave Ste 3
Oklahoma City, OK 73103-1345 - Phone
- (405) 464-1655
- NPI assigned
- Apr 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R0103974 | OK | |
| Nurse Practitioner | 363L00000X | 206107 | OK | Primary |
Addresses
Primary practice location
2807 N Walker Ave Ste 3
Oklahoma City, OK 73103-1345
Mailing address
9029 NW 146TH St
Yukon, OK 73099-4738
Phone (405) 464-1655
Other practice location 1
9029 NW 146th St
Yukon, OK 73099-4738
Phone (405) 464-1655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0103974 | OK | MD | Registered Nurse |
| 206107 | OK | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1871175166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9029 NW 146TH ST",
"city": "YUKON",
"state": "OK",
"postal_code": "730994738",
"telephone_number": "405-464-1655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2807 N WALKER AVE STE 3",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731031345",
"telephone_number": "405-464-1655"
}
],
"practiceLocations": [
{
"address_1": "9029 NW 146th St",
"address_purpose": "LOCATION",
"city": "Yukon",
"state": "OK",
"postal_code": "730994738",
"country_code": "US",
"telephone_number": "405-464-1655",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JANTZ",
"first_name": "ADRIENNE",
"middle_name": "MARIE",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-26",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "R0103974",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "206107",
"primary": true
}
],
"identifiers": [],
"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 Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.