Jessica Funk, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

106355 Issued in OK

Practice address

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3099

Phone

(580) 354-5400

Fax

(580) 354-5409

NPI assigned

Sep 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jessica Hale Former name

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lawton Indian HospitalGroup PAC ID 6406800234, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawton Indian Hospital Hospital, Lawton, OK, CCN 370170

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lawton Indian Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1760489223

  TX

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Anadarko Indian Health Center

  • Federal Public Health Clinic/Center
  • Anadarko, OK
  • NPI 1881637403

  Hospital

  Care Compare affiliation
• Carnegie Indian Health Center

  • Federal Public Health Clinic/Center
  • Carnegie, OK
  • NPI 1457459158

  Hospital

  Care Compare affiliation
• Clinton Indian Health Center

  • Federal Public Health Clinic/Center
  • Clinton, OK
  • NPI 1205923448

  Hospital

  Care Compare affiliation
• El Reno Indian Health Center

  • Public Health or Welfare Agency
  • El Reno, OK
  • NPI 1386725604

  Hospital

  Care Compare affiliation
• Lawton Indian Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1760489223
  Care Compare affiliation
• Watonga Indian Health Center

  • Public Health or Welfare Agency
  • Watonga, OK
  • NPI 1558458794

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1912376740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073099",
            "telephone_number": "580-354-5400",
            "fax_number": "580-354-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073099",
            "telephone_number": "580-354-5400",
            "fax_number": "580-354-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "106355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HALE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brooklyn Frovarp, RN
• Heather Elaine Fry
• Kathryn Frye-Davies, MT-BC, LPMT
• Arzola Fuller
• Steven Michael Fuller, LPC, LMFT
• Cynthia L Gable, M.S.,CCC-SLP
• David Gabriele
• Pamela F Gaddis
• Ronald Lynn Gaddis II
• Margarette Raquelle Gager

• Nurse Practitioner in Lawton, OK
• Providers in Lawton, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.