NPI 1902773021 · live from the CMS NPI Registry
John Matthew Antonelli
Nurse Practitioner, Family in Sand Springs, OK. National Provider Identifier 1902773021, active.
NPI record
| NPI | 1902773021 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 1313 S 221st West Ave, Sand Springs, OK 74063 |
| Practice phone | 918-289-5583 |
| Enumerated | October 22, 2025 |
| Last updated | December 5, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | 108524 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.