KETTI LYNN EDDY (APRN-CNP) – Family Nurse Practitioner, NPI 1194723239
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KETTI LYNN EDDY (APRN-CNP)
West Memorial Road, Oklahoma City, Oklahoma County, Oklahoma, 73142, United States
140
OKLAHOMA CITY, OK 731341785
Phone: (405) 752-3162
Fax: (405) 936-5211
Type: Mailing
1603 HUNTERS PATH
EDMOND, OK 730341627
Phone: (405) 919-7570
Fax: (405) 256-9748
Type: Mailing
105 E INDUSTRIAL RD STE B
GUTHRIE, OK 730446971
Phone: (405) 919-7570
Fax: (405) 256-9748
Type: Location
Mercy Convenient Care - Guthrie Division, 2919, South Division Street, Guthrie, Logan County, Oklahoma, 73044, United States
GUTHRIE, OK 730446806
Phone: (405) 282-6301
Fax: (405) 282-6364
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: 2005-08-24
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 |
|---|---|---|---|---|
| I20050824000639 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73134)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | OK | |
| Nurse Practitioner | OK | |
| Orthopedic Surgery | OK | |
| - | OK | |
| P O D I A T R Y | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OK | |
| Internal Medicine | TX | |
| U R O L O G Y | OK | |
| - | OK | |
| Orthopedic Surgery | TN |
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