Individual provider Active NPI

Agnes Tonkumoh, CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1891294906
Registry record updated Feb 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
90102 Issued in OK
Practice address
11600 Shasta LN
Oklahoma City, OK 73162-1601
Phone
(405) 923-2933
NPI assigned
Feb 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 90102 OK Primary

Addresses

Primary practice location

11600 Shasta LN
Oklahoma City, OK 73162-1601

Mailing address

11600 Shasta LN
Oklahoma City, OK 73162-1601
Phone (405) 923-2933

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
I20240510001704 OK Practitioner - Nurse Practitioner 5698116499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oklahoma Cancer and Blood Specialists LLCGroup PAC ID 4981874849, 12 clinicians

Practice addresses (Care Compare)

100 N 30TH St
Clinton, OK 73601-3117
Phone (405) 752-0871

11100 Hefner Pointe Dr
Suite a
Oklahoma City, OK 73120-5049
Phone (405) 752-0871

2408 E 81St St
Suite 110
Tulsa, OK 74137-4215
Phone (405) 752-0871

4400 Grant Blvd
Yukon, OK 73099-0037
Phone (405) 752-0871

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90102OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer and Blood Specialists, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

100 N 30th St
Clinton, OK 73601
Phone (580) 323-2363

11100 Hefner Pointe Dr
Ste A
Oklahoma City, OK 73120
Phone (405) 752-0871

4400 Grant Blvd
Yukon, OK 73099
Phone (405) 467-4440

Organizations & group practices 1

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.

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": "1517702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517702400000",
    "number": "1891294906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 SHASTA LN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731621601",
            "telephone_number": "405-923-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 SHASTA LN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731621601",
            "telephone_number": "405-923-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONKUMOH",
        "first_name": "AGNES",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-04",
        "last_updated": "2018-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "90102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.