Individual provider Active NPI

Krystle Renee O'Dowd, APRN-CNP

  • Nurse Practitioner
  • Bartlesville, OK
National Provider Identifier
1922767631
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
206196 Issued in OK
Practice address
6006 SE Adams Blvd
Bartlesville, OK 74006-8960
Phone
(918) 331-0550
NPI assigned
Dec 9, 2021
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 206196 OK Primary

Addresses

Primary practice location

6006 SE Adams Blvd
Bartlesville, OK 74006-8960

Mailing address

7128 S Canton Ave
Tulsa, OK 74136-6303
Phone (918) 695-9294

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www20.pointclickcare.com

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
I20220208002917 OK Practitioner - Nurse Practitioner 7810380151 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians
Prime Medical Group CorpGroup PAC ID 9032597257, 12 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2071

2621 E 38TH St
Tulsa, OK 74105-8206
Phone (708) 724-8599

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206196OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Feb 4, 2026 Accepting new patients
Prime Medical Group Corp CurrentSince Apr 1, 2024 Accepting new patients
St. John Physicians, Inc. CurrentSince Feb 4, 2026 Accepting new patients
Prime Physician Staffing 3 LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

6006 SE Adams Blvd
Bartlesville, OK 74006
Phone (405) 843-5855

10020 E 91st St
Tulsa, OK 74133
Phone (918) 720-7046

3219 S 79th East Ave
Tulsa, OK 74145
Phone (833) 524-2400

744 W 9th St
Fl 5
Tulsa, OK 74127
Phone (918) 932-3700

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.

Hospital & facility affiliations 4

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": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1922767631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7128 S CANTON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366303",
            "telephone_number": "918-695-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 SE ADAMS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740068960",
            "telephone_number": "918-331-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DOWD",
        "first_name": "KRYSTLE",
        "middle_name": "RENEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "206196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www20.pointclickcare.com",
            "affiliation": "N",
            "address_1": "6006 SE Adams Blvd",
            "city": "Bartlesville",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740068960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.