LORI LYN ENLOW (NPI# 1700875598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700875598 |
| Entity Type | Individual |
| Full Name | LORI LYN ENLOW |
| Other Name | LORI LYN RAGSDALE |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1203 E Ross Byp Suite A Tahlequah OK 74464 |
| Mailing Address |
1203 E Ross Byp Ste A Tahlequah OK 74464-4158 |
| Practice Telephone | 9184531234 |
| Practice Fax Number | 9184539107 |
| Mailing Telephone | 9184531234 |
| Mailing Fax Number | 9184539107 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2019-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R0067005 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | RAILROAD MEDICARE GROUP NUMBER | DA5295 | 01 |
| OK | 200073760A | 05 | |
| OK | MEDICARE GROUP PTAN | 400522239 | 01 |
| OK | RAILROAD MEDICARE PIN NUMBER | P00399872 | 01 |
| OK | MEDICAID GROUP NUMBER | 200000030A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 E Downing St Ste 101, Tahlequah, OK 744643354 | 9187083570 | 9184532772 |
| Street Address |
1203 E ROSS BYP SUITE A |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073164125 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2019-09-20 |
| 1023311438 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 | 2010-12-08 |
| 1649584855 | Lea Sarah Humphrey | Otolaryngology | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-29 |
| 1316258619 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-01 |
| 1659568301 | Cmg Family Clinic LLC | Family Medicine | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-09-26 |
| 1720274699 | Tracey W. Childers, D.o. P.C. | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2007-09-24 |
| 1730227299 | Philip Dean Watson | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-02-04 |
| 1568412310 | Susan K Anderson | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2006-05-11 |
| 1053371021 | Tracey Way Childers | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2006-03-24 |
| 1114909843 | Andrea D Mitchell | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2005-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568885499 | Rebekah Leanne Gray | Nurse Practitioner | Tahlequah Family Medicine Clinic, 204 Woodlawn Ave, Tahlequah, OK 74464 | 2014-01-29 |
| 1083842520 | Tracy L Ross | Nurse Practitioner | 1387 W 4th St, Tahlequah, OK 74464-9766 | 2009-06-23 |
| 1902246150 | Jennifer Leigh Carter | Nurse Practitioner | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2013-07-02 |
| 1477784924 | Timothy Richard Burmaster | Nurse Practitioner | 100 S Bliss Ave, Medical Staffing, Tahlequah, OK 74464-2512 | 2009-07-31 |
| 1417071036 | Deshea Donovan Carter | Nurse Practitioner | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457968695 | Christi Howell | Nurse Practitioner | 2304 Burning Tree, Norman, OK 73071-3919 | 2020-09-30 |
| 1093322240 | Lacey Campbell | Nurse Practitioner | 6124 Beverly Hills Dr, Edmond, OK 73034-8690 | 2020-09-30 |
| 1700403037 | Molly Lewis | Nurse Practitioner | 9001 S 101st East Ave Ste 230, Tulsa, OK 74133-5797 | 2020-07-02 |
| 1407471402 | Brenda June Wilson | Nurse Practitioner | 8609 Sw 58th Cir, Oklahoma City, OK 73179-7910 | 2020-06-15 |
| 1972139558 | Sammi Noel Pulliam | Nurse Practitioner | 700 W 7th Ave Ste 104, Bristow, OK 74010-2302 | 2020-03-16 |
| 1760017321 | Jennyfer Lynn Livingston | Nurse Practitioner | 105 S Bryant Ave # 205, Edmond, OK 73034-6399 | 2020-03-04 |
| 1336772771 | Lisa M Johnson | Nurse Practitioner | 3500 E Frank Phillips Blvd Ste 501, Bartlesville, OK 74006-2411 | 2020-02-13 |
| 1770123655 | Jennifer Katherine Yeaman | Nurse Practitioner | 4905 Nw 155th St, Edmond, OK 73013-9666 | 2020-01-08 |
| 1912546144 | Michelle Johnson | Nurse Practitioner | 1825 Preakness Path, Guthrie, OK 73044-7880 | 2020-01-06 |
| 1265071922 | Kristi Michelle Cooksey | Nurse Practitioner | 4713 Marston Ct, Norman, OK 73072-3116 | 2019-12-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.