Individual provider Active NPI

Philomina Philipose, FNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1952917239
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113189 Issued in OK
Practice address
8805 NW 116TH St
Oklahoma City, OK 73162-2220
Phone
(405) 250-5772
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 113189 OK Primary

Addresses

Primary practice location

8805 NW 116TH St
Oklahoma City, OK 73162-2220

Mailing address

8805 NW 116TH St
Oklahoma City, OK 73162-2220
Phone (405) 250-5772

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
I20241125000845 OK Practitioner - Nurse Practitioner 6507391745 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113189OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Oct 18, 2024 Accepting new patients

Locations

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1952917239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 NW 116TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731622220",
            "telephone_number": "405-250-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 NW 116TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731622220",
            "telephone_number": "405-250-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPOSE",
        "first_name": "PHILOMINA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "113189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.