VICTORIA BROOKE BLAYLOCK (FNP-C) – Family Nurse Practitioner, NPI 1144009143
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,299 NURSE PRACTITIONER in OK
Provider Addresses for VICTORIA BROOKE BLAYLOCK (FNP-C)
108 NE 6TH ST
WILBURTON, OK 745783012
Phone: (918) 638-4182
Type: Mailing
340 S GEORGE NIGH EXPY
MCALESTER, OK 745016075
Phone: (918) 420-9854
Type: Location
340 S George Nigh Expy
McAlester, OK 745016075
Phone: (918) 420-9854
Type: Location
PO BOX 776084
CHICAGO, IL 606776084
Phone: (479) 314-6245
Type: Mailing
7301 ROGERS AVE
FORT SMITH, AR 729034100
Phone: (479) 314-6245
Fax: (479) 452-0275
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231117002192 | I | Nurse Practitioner | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 16 | 16 | $0 |
Insurance plans in this area (ZIP 74578)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | OK | |
| Physician Assistant | OK | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | OK | |
| Internal Medicine, Pediatric Medicine | OK | |
| Hospitalist, Internal Medicine, Internal Medicine | TX | |
| Nurse Practitioner | OK | |
| - | KS | |
| Clinical Social Worker | OK | |
| Nurse Practitioner | OK |
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