Barome Enoweyere, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Granite, OK
NPI 1992381982 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1992381982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 201364 (OK)
- Practice address
- 1700 E 1St St
Granite, OK 73547-9317 - Phone
- (580) 480-3700
- NPI assigned
- Mar 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advance Physicians Group
Practice addresses (Care Compare)
7807 S Walker Ave
Oklahoma City, OK 73139-9470
Phone (405) 636-0767
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 |
|---|---|---|---|---|
| I20240425003095 | OK | Practitioner - Nurse Practitioner | 7911347851 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Medical LLC | Current |
Accepting new patients | |
| US Wound LLC | Current |
Accepting new patients | |
| Advance Physicians Group | Current |
Accepting new patients | |
| Pathways Professional Counseling LLC | Current |
Accepting new patients |
Locations
13707 Fairhill Ave
Edmond, OK 73013
Phone (405) 412-3494
3103 Azalea Park Dr
Muskogee, OK 74401
Phone (405) 759-4300
7807 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 636-0767
4510 NW 39th St
Oklahoma City, OK 73122
Phone (405) 495-5841
11521 S Western Ave
Ste B
Oklahoma City, OK 73170
Phone (405) 676-9125
10401 W Reno Ave
Fl 1
Oklahoma City, OK 73127
Phone (877) 969-6863
4010 N Kickapoo Ave
Ste 3
Shawnee, OK 74804
Phone (405) 759-4300
1810 8th Ave
Ste A101
Fort Worth, TX 76110
Phone (877) 969-6863
Interoperability endpoints
- https://api.platform.athenahealth.com/13010/brand/1/csg/1/fhir/r4
- barome.enoweyere.1@21577.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201364 | OK | Yes |
Addresses
Primary practice location
1700 E 1St St
Granite, OK 73547-9317
Mailing address
1700 E 1St St
Granite, OK 73547-9317
Phone (580) 480-3700
Other practice location 1
12616 William Penn Blvd
Oklahoma City, OK 73120-3527
Phone (469) 269-4171
Other providers in Granite, OK
- Robert Louis Albright
- Robert L Bernard
- Blackhawk Mangum, LLC
- Ashlee Brewer
- Tressa Brewer
- Granite Drug, Inc
- Greer County Independent School District #3
- Murray Drug Co. LLC
- Katherine Elizabeth Murray
- N Evans Einterprises LLC
All providers in Granite, 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 Aug 18, 2021. 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.