Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Larry Ray Tevebaugh Jr., NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1619560984

Larry Ray Tevebaugh Jr., NURSEPRACTITIONER is a Nurse Practitioner in Yukon, Oklahoma. Qualified in 2021, 5 years ago. Practices with Optimum Post Acute Care PLLC, an 18-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2021
Specialties on file
2

Practice location Address checks out

4400 Grant Blvd
Yukon, OK 73099-0037
Phone: (405) 830-5574
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1619560984 (OK)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence R0094181 (OK)

Record details

NPI number1619560984
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedFebruary 17, 2021
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Optimum Post Acute Care Pllc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Yukon