Individual provider Active NPI

Kristen Michelle Clouse, APRN CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Idabel, OK
National Provider Identifier
1902278260
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
99530 Issued in OK
Practice address
108 S Central Ave
Idabel, OK 74745-4848
Phone
(580) 208-2395
Fax
(580) 208-2396
NPI assigned
Oct 27, 2015
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 99530 OK Primary

Addresses

Primary practice location

108 S Central Ave
Idabel, OK 74745-4848

Mailing address

108 S Central Ave
Idabel, OK 74745-4848
Phone (580) 208-2395

Other practice location 1

72 Forsyth St Apt 6
New York, NY 10002-5157
Phone (903) 900-0725

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
I20160216001343 OK Practitioner - Nurse Practitioner 1153626957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

108 S Central Ave
Idabel, OK 74745-4848
Phone (580) 208-2395

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jane M Harmon DNP,RN,Pmhnp-BC,PLLC Psychiatric/Mental Health CurrentSince May 3, 2016 Accepting new patients
Kristen Clouse DNP, Pmhnp-BC, LLC Psychiatric/Mental Health CurrentSince Feb 4, 2016 Accepting new patients

Locations

108 S Central Ave
Idabel, OK 74745
Phone (580) 208-2395

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1902278260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S CENTRAL AVE",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747454848",
            "telephone_number": "580-208-2395",
            "fax_number": "580-208-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S CENTRAL AVE",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747454848",
            "telephone_number": "580-208-2395",
            "fax_number": "580-208-2396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 Forsyth St Apt 6",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100025157",
            "country_code": "US",
            "telephone_number": "903-900-0725",
            "fax_number": "330-662-6702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "APRN CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "99530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.