Individual provider Active NPI

Nicoline Lami Edie, FNP

  • Family Nurse Practitioner
  • Piedmont, OK
National Provider Identifier
1992274724
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0118299 Issued in OK
Practice address
11657 NW 136TH Ter
Piedmont, OK 73078-8777
Phone
(405) 501-8806
NPI assigned
Nov 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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 R0118299 OK Primary

Addresses

Primary practice location

11657 NW 136TH Ter
Piedmont, OK 73078-8777

Mailing address

11657 NW 136TH Ter
Piedmont, OK 73078-8777
Phone (405) 501-8806

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
I20231116002561 OK Practitioner - Nurse Practitioner 3476900184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
KP Medical Group LLCGroup PAC ID 1153559752, 4 clinicians

Practice addresses (Care Compare)

2301 W I 44 Service Rd
Suite 300
Oklahoma City, OK 73112-8766
Phone (405) 607-2233

7415 NW 23Rd St
Bethany, OK 73008-5135
Phone (405) 251-9959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
KP Medical Group, LLC CurrentSince Oct 7, 2023 Accepting new patients
Reliance Mental Health Clinic CurrentSince Feb 28, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Jan 1, 2026 Accepting new patients
Mark B. Privott, O.D., Inc PastSince May 8, 2024 Accepting new patients

Locations

7415 NW 23rd St
Bethany, OK 73008
Phone (405) 251-9959

2301 W I 44 Service Rd
Ste 300
Oklahoma City, OK 73112
Phone (405) 286-4359

101 Park Ave
Oklahoma City, OK 73102
Phone (405) 442-4940

Organizations & group practices 4

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": "1542844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1992274724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11657 NW 136TH TER",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730788777",
            "telephone_number": "405-501-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11657 NW 136TH TER",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730788777",
            "telephone_number": "405-501-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDIE",
        "first_name": "NICOLINE",
        "middle_name": "LAMI",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-22",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0118299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, OK

Sources for this page

Verify at the official NPI Registry.