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DR. KYLE CHANDLER EDDINGTON DO
NPI 1417515636
Student in an Organized Health Care Education/Training Program in Oklahoma City, OK

Active since June 03, 2019PECOS Enrolled
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104(405) 271-4417 Get Directions Write a Review

NPPES record last updated: June 3, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Kyle Chandler Eddington Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KYLE CHANDLER EDDINGTON DO (NPI 1417515636) is an individual student in an organized health care education/training program in Oklahoma City, Oklahoma and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417515636
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. KYLE CHANDLER EDDINGTONCredential: DO
Location Address1200 CHILDRENS AVEOklahoma City, OK 73104-4637
Mailing Address1200 Childrens AveOklahoma City, OK 73104-4637 · (405) 271-4417
Phone(405) 271-4417
Sole ProprietorYes
Enumeration DateJune 3, 2019
✔ NPI 1417515636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1200 CHILDRENS AVE, Oklahoma City, OK 73104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kyle Chandler Eddington Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kyle Eddington reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
1,328 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRUTI SHAH
Student in an Organized Health Care Education/Training Program
1200 CHILDRENS AVE, SUITE 4D
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-8001
MRS. RACHEL LEIGH CROSS APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
1200 CHILDRENS AVE, SUITE 10000
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4412
KAYLEE MARTIN
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-5437
KRISTEN PUENTE RD, LD
Dietitian, Registered
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700
ROA MUQBEL
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
DR. CLAIRE ELIZABETH KUNKEL SMITH DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
JAY OGLE DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
BLAYNE BORDWINE
Pediatrics (Hospice and Palliative Medicine)
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Eddington's NPI number?

The NPI number for Kyle Eddington is 1417515636. It was assigned to this individual provider in the NPPES registry on June 3, 2019.

Where is Kyle Eddington located?

Kyle Eddington practices at 1200 Childrens Ave, Oklahoma City, OK 73104. The listed phone number is (405) 271-4417.

What is Kyle Eddington's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kyle Eddington enrolled in Medicare?

Yes. Kyle Eddington is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kyle Eddington's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kyle Eddington reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyle Eddington's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kyle Eddington was last updated on June 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.