Individual provider Active NPI

Jennifer Renhae Dorsey, APRN

  • Family Nurse Practitioner
  • Anadarko, OK
National Provider Identifier
1972939122
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
93355 Issued in OK
Practice address
1104 E Central Blvd
Anadarko, OK 73005-4406
Phone
(405) 247-6685
Fax
(405) 247-2043
NPI assigned
Sep 19, 2013
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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 93355 OK Primary

Addresses

Primary practice location

1104 E Central Blvd
Anadarko, OK 73005-4406

Mailing address

2222 W Iowa Ave
Chickasha, OK 73018-2738
Phone (405) 224-8111

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
I20140819002747 OK Practitioner - Nurse Practitioner 1052539855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2222 W Iowa Ave
Chickasha, OK 73018-2738

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93355OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Plains Medical Center Inc CurrentSince Jun 15, 2015 Accepting new patients
Southern Plains Medical Center Inc CurrentSince Jun 15, 2015 Accepting new patients
Southern Plains Medical Center Inc Current Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Lawton Urology Past Accepting new patients
Ghazi M. Rayan, MD, Inc. Past Accepting new patients

Locations

1104 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-6685

2222 W Iowa Ave
Chickasha, OK 73018
Phone (405) 592-3937

Organizations & group practices 7

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1972939122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182738",
            "telephone_number": "405-224-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E CENTRAL BLVD",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730054406",
            "telephone_number": "405-247-6685",
            "fax_number": "405-247-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "JENNIFER",
        "middle_name": "RENHAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "93355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anadarko, OK

Sources for this page

Verify at the official NPI Registry.