Individual provider Active NPI

Tana M Stutzman, ARNP

  • Women's Health Nurse Practitioner
  • Pryor, OK
National Provider Identifier
1902882269
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R0071260 Issued in OK
Practice address
14 S Vann St
Pryor, OK 74361-3613
Phone
(918) 825-4800
Fax
(918) 825-4809
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R0071260 OK Primary

Addresses

Primary practice location

14 S Vann St
Pryor, OK 74361-3613

Mailing address

14 S Vann St
Pryor, OK 74361-3613
Phone (918) 825-4800

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
I20060925000533 OK Practitioner - Nurse Practitioner 1456356492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

2617 S Elm PL
Suite 100
Broken Arrow, OK 74012-7850
Phone (918) 455-4541

Hospital & facility affiliations

  • Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0071260OKMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC CurrentSince Feb 1, 2018 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Feb 1, 2018 Accepting new patients
Abc Chiropractic Inc Past Accepting new patients
Ahs Southcrest Hospital, LLC Past Accepting new patients

Locations

2617 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 455-4541

2617 S Elm Pl
Ste 100
Broken Arrow, OK 74012
Phone (918) 455-4541

1301 NE 1st St
Ste 400
Pryor, OK 74361
Phone (918) 824-7714

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

Dept 1206
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: tstutzman152273@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1902882269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S VANN ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743613613",
            "telephone_number": "918-825-4800",
            "fax_number": "918-825-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S VANN ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743613613",
            "telephone_number": "918-825-4800",
            "fax_number": "918-825-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "TANA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R0071260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.