Individual provider Active NPI

Nikki Harrison Carter, MD

  • Hospitalist Physician
  • Tulsa, OK
National Provider Identifier
1992852701
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
33787 Issued in OK
Practice address
1705 E 19TH St Ste 302
Tulsa, OK 74104
Phone
(918) 748-7684
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2015-01976 NC
Hospitalist Physician 208M00000X 33787 OK Primary

Addresses

Primary practice location

1705 E 19TH St Ste 302
Tulsa, OK 74104

Mailing address

1705 E 19TH St Ste 302
Tulsa, OK 74104-5410
Phone (918) 748-7684

Other practice location 1

1155 Revolution Mill Dr
Studio 12
Greensboro, NC 27405-5089
Phone (336) 402-2532

Other practice location 2

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-4380

Other identifiers 1

IdentifierTypeStateIssuer
1506085MedicaidTN

Other names 1

  • Nikki Patrice Harrison Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160301002610 NC Practitioner - HospitalistPractitioner - Internal Medicine 9436201183 Reassigns benefits to 1 organization
I20181010002957 OK Practitioner - Internal Medicine 9436201183 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015-01976NCMDHospitalist Physician
33787OKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. CurrentSince Oct 15, 2018 Accepting new patients
Moses Cone Physician Services Inc Hospitalist CurrentSince Dec 20, 2015 Accepting new patients
St. John Physicians, Inc CurrentSince Oct 15, 2018 Accepting new patients
Moses Cone Physician Services, Inc. Current Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1992852701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045410",
            "telephone_number": "918-748-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-7684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Revolution Mill Dr",
            "address_2": "Studio 12",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274055089",
            "country_code": "US",
            "telephone_number": "336-402-2532",
            "fax_number": "866-941-5258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011004",
            "country_code": "US",
            "telephone_number": "336-832-4380",
            "fax_number": "336-832-4382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "NIKKI",
        "middle_name": "HARRISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2015-01976",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "33787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506085",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "HARRISON",
            "middle_name": "PATRICE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.