Individual provider Active NPI

Colleen Afadama

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1902392483
Registry record updated Dec 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP137914 Issued in TX
Practice address
10204 Hawthorn Dr
Oklahoma City, OK 73120-2800
Phone
(405) 833-1184
NPI assigned
Jul 8, 2018
Last updated
Dec 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2019

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 AP137914 TX Primary

Addresses

Primary practice location

10204 Hawthorn Dr
Oklahoma City, OK 73120-2800

Mailing address

10204 Hawthorn Dr
Oklahoma City, OK 73120-2800
Phone (405) 833-1184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190326000834 TX Practitioner - Nurse Practitioner 4789924945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.97 of 100Reported as group
Quality
43.69
Promoting interoperability
91
Improvement activities
40
Cost
67.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP137914TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Dec 5, 2018 Accepting new patients
North Texas Vascular & Varicose CurrentSince Apr 1, 2024 Accepting new patients
Premier Interventional Pain Management, P.L.L.C CurrentSince Dec 5, 2018 Accepting new patients
Medical Care Transportation LLC Current Accepting new patients

Locations

2321 Olympia Dr
Ste 100
Flower Mound, TX 75028
Phone (972) 350-0225

2321 Olympia Dr
Ste 100A
Flower Mound, TX 75028
Phone (972) 350-0225

777 Main St
Ste 100
Frisco, TX 75036
Phone (972) 378-5347

300 S Nolen Dr
Ste 140
Southlake, TX 76092
Phone (817) 488-0410

620 N Kimball Ave
Ste 100
Southlake, TX 76092
Phone (817) 328-8376

Organizations & group practices 4

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": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577577600000",
    "number": "1902392483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 HAWTHORN DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202800",
            "telephone_number": "405-833-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10204 HAWTHORN DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202800",
            "telephone_number": "405-833-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFADAMA",
        "first_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-08",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.