Individual provider Active NPI

Tammy Nicole Onafowokan, APRN-CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1972218550
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202646 Issued in OK
Practice address
5901 W Memorial Rd
Oklahoma City, OK 73142-2015
Phone
(405) 259-4831
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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 202646 OK Primary

Addresses

Primary practice location

5901 W Memorial Rd
Oklahoma City, OK 73142-2015

Mailing address

5901 W Memorial Rd
Oklahoma City, OK 73142-2015

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
I20230222002327 OK Practitioner - Nurse Practitioner 4587037536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202646OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Proton Center LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

3300 NW 56th St
Fl LL100
Oklahoma City, OK 73112
Phone (405) 488-0700

5901 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 773-6700

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1972218550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422015",
            "telephone_number": "405-259-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONAFOWOKAN",
        "first_name": "TAMMY",
        "middle_name": "NICOLE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "202646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.