Kimberly Reece, NP-C
Individual provider Active NPI Family Nurse Practitioner · Broken Bow, OK
NPI 1992170609 · NPPES record last updated Jun 2, 2022
Key facts
- NPI
- 1992170609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 99244 (OK)
- Practice address
- 1516 Peavey Crossing Rd
Broken Bow, OK 74728-5637 - Phone
- (580) 306-2979
- NPI assigned
- Dec 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Stathealth Clinic PLLC
Practice addresses (Care Compare)
805 E Washington St
Idabel, OK 74745-3331
Phone (580) 286-1095
Hospital & facility affiliations
- Mays Housecall Home Health of South East Ok, LLC
- Complete Home Health of Tishomingo LLC
- McCurtain Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160516002458 | OK | Practitioner - Nurse Practitioner | 9931498813 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99244 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stathealth Clinic PLLC | Current |
Accepting new patients | |
| McCurtain Memorial Medical Management, Inc. | Past | Accepting new patients |
Locations
805 E Washington St
Idabel, OK 74745
Phone (580) 286-1095
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 99244 | OK | Yes |
Addresses
Primary practice location
1516 Peavey Crossing Rd
Broken Bow, OK 74728-5637
Mailing address
1516 Peavey Crossing Rd
Broken Bow, OK 74728-5637
Phone (580) 306-2979
Other providers in Broken Bow, OK
- Faith Lucille Phillips
- Professional Counseling Associates of McCurtain County, Inc.
- Shannon Jewelanna Pruett
- Pruetts Food Inc
- Jessica Pruitt
- Chelsea Richardson
- Jacqueline Sue Rollins
- Sequelcare of Oklahoma
- Sequelcare of Oklahoma, LLC
- Sequelcare of Oklahoma, LLC
All providers in Broken Bow, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.