Individual provider Active NPI

Charlsie Record

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1972028249
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0104700 Issued in OK
Practice address
10413 Greenbriar Pkwy
Oklahoma City, OK 73159-7656
Phone
(405) 691-4665
Fax
(405) 378-7628
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 104700 OK
Family Nurse Practitioner 363LF0000X R0104700 OK Primary

Addresses

Primary practice location

10413 Greenbriar Pkwy
Oklahoma City, OK 73159-7656

Mailing address

9101 Woodrow CT
Oklahoma City, OK 73169-3702

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
I20180418000429 OK Practitioner - Nurse Practitioner 9537422936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riaz a. Sirajuddin MD PCGroup PAC ID 7012988579, 3 clinicians

Practice addresses (Care Compare)

10413 Greenbriar Pkwy
Oklahoma City, OK 73159-7656
Phone (405) 691-4665

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • The Physicians' Hospital in Anadarko Hospital, Anadarko, OK, CCN 371314
  • Oklahoma Heart Hospital South, LLC Hospital, Oklahoma City, OK, CCN 370234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0104700OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riaz a. Sirajuddin MD PC CurrentSince Mar 11, 2018 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

10413 Greenbriar Pkwy
Oklahoma City, OK 73159
Phone (405) 691-4665

Organizations & group practices 3

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 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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1972028249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 WOODROW CT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731693702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10413 GREENBRIAR PKWY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597656",
            "telephone_number": "405-691-4665",
            "fax_number": "405-378-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECORD",
        "first_name": "CHARLSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "104700",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0104700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.