STEPHANE LYNN JUDD – Nurse Practitioner, NPI 1407638513

STEPHANE LYNN JUDD is a healthcare provider. based in Wewoka, Oklahoma. specializing in NURSE PRACTITIONER. They hold a License No. 219036 (OK). The NPI Number for STEPHANE LYNN JUDD is 1407638513

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANE LYNN JUDD
NPI
1407638513
Phone
(405) 257-5422
Address
207 W 1st St
Enumeration Date
16 October 2023
Last Update Date
6 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4054525400
Graduation Year
2024 (2 years ago)
PAC ID
8527506286
Group Practice PAC ID
3779643994
Professional Enrollment ID
I20240813003970
Address ID
OK748834015WE109XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for STEPHANE LYNN JUDD

  • 207 W 1st St

    Wewoka, OK 748842103

    Phone: (405) 257-5422

    Fax: (405) 257-5463

    Type: Location

  • 1102 W Main St

    Henryetta, OK 744374232

    Phone: (918) 652-9615

    Fax: (918) 652-7612

    Type: Location

  • 104 E Shurden Industrial Blvd

    Henryetta, OK 744377323

    Phone: (918) 652-9614

    Fax: (918) 652-4831

    Type: Location

  • PO BOX 236

    WETUMKA, OK 748830236

    Phone: (405) 452-5400

    Fax: (405) 452-3000

    Type: Mailing

  • 109 S MAIN ST

    WETUMKA, OK 748834015

    Phone: (405) 452-5400

    Fax: (405) 452-3000

    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: 2024-08-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240813003970INurse PractitionerOKTBD

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.

Verify on CMS Revalidation Lookup Tool

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 74884)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779643994View full group profile
NameSpecialtyState
Clinical Social WorkerOK
-OK
Family Practice, Obstetrics/GynecologyME
Nurse PractitionerOK
Physician AssistantOK
-OK
Family PracticeOK
Mental Health CounselorOK
Nurse PractitionerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Does STEPHANE LYNN JUDD share an NPI with anyone else?
NPI numbers are unique to each provider or organization — STEPHANE LYNN JUDD uses 1407638513.
Is STEPHANE LYNN JUDD listed as active for patients and plans?
The listing shows STEPHANE LYNN JUDD as active in the NPI system.
What is STEPHANE LYNN JUDD's specialty?
The listing groups STEPHANE LYNN JUDD with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does STEPHANE LYNN JUDD list a practice location?
Patients near Wewoka, Oklahoma may find STEPHANE LYNN JUDD in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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