LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) – General Practice Registered Nurse, NPI 1619560984

LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. R0094181 (OK). The NPI Number for LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) is 1619560984

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER)
NPI
1619560984
Phone
(405) 830-5574
Address
6600 NW 134TH ST
Enumeration Date
17 February 2021
Last Update Date
26 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4059142356
Graduation Year
2021 (5 years ago)
PAC ID
5092158600
Group Practice PAC ID
5799162111
Professional Enrollment ID
I20240212001228
Address ID
OK730136618ED1501XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER)

  • 6600 NW 134TH ST

    OKLAHOMA CITY, OK 731425909

    Phone: (405) 830-5574

    Mailing address matches the actual address.

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: 2024-02-12

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
I20240212001228INurse 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 73142)

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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: 5799162111View full group profile
NameSpecialtyState
Internal MedicineOK
Family PracticeOK
Nurse PractitionerOK
Internal MedicineOK
Internal MedicineNY
Family PracticeOK
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I cross-check LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) using NPI 1619560984?
NPI 1619560984 belongs to LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER); compare other details if you need extra assurance.
Would LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) appear as active to a payer?
You can treat LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER)'s focus?
For LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER), the primary taxonomy reads as General Practice Registered Nurse. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER)?
Travel planning: use Oklahoma City, Oklahoma as the reference point for LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER), then confirm.
Can I trust this NPI listing for LARRY RAY JR. TEVEBAUGH (NURSE PRACTITIONER)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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