Quinton Ty Bohannon, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2239 Issued in OK

Practice address

108 W Ohio Ave
Coalgate, OK 74538-2827

Phone

(580) 927-2334

NPI assigned

Jan 30, 2013

Last updated

Jan 30, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspire Health Management LLCGroup PAC ID 6305235565, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspire Health Management, LLC

  dba Aspire Health

  • General Practice Physician
  • Checotah, OK
  • NPI 1053984518
  Medicare reassignment Care Compare group
• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment
• Muskogee Medical Care PLLC

  • Family Medicine Physician
  • Muskogee, OK
  • NPI 1629368105
  Medicare reassignment
• Urgent Care of Muskogee PLLC

  • Medical Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1740678622
  Medicare reassignment
• Creek Nation Hospital & Clinics

  dba Muscogee Healing and Recovery Center

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Urgent Care of Muskogee PLLC

  • Urgent Care Clinic/Center
  • Wagoner, OK
  • NPI 1871120022
  NPD
• Coal County General Hospital

  dba Mary Hurley Hospital

  • Critical Access Hospital
  • Coalgate, OK
  • NPI 1629077227
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Hospital Muskogee Inc

  dba Saint Francis Hospital Muskogee

  • General Acute Care Hospital
  • Muskogee, OK
  • NPI 1386188837
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1003154725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W OHIO AVE",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745382827",
            "telephone_number": "580-927-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W OHIO AVE",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745382827",
            "telephone_number": "580-927-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "QUINTON",
        "middle_name": "TY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Path of Care Home Health IV, LLC (TenderCare Home Health)
• Carol Lynn Black, APRN-CNP
• Joy Burris, LPC
• Matt Calvert
• City of Coalgate
• Coal County Extended Care Incorporated (Ruth Wilson Hurley Manor)
• Coal County General Hospital (Mary Hurley Hospital)

• Medical Physician Assistant in Coalgate, OK
• Providers in Coalgate, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.