Kelsey Haughton, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2349 Issued in OK

Practice address

1505 E Main St
Stigler, OK 74462-2913

Phone

(918) 967-3368

NPI assigned

Jan 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsey Blome Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelsey.haughton.1@32614.direct.athenahealth.com

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

• Stigler Health and Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stigler, OK
  • NPI 1891752853
  Medicare reassignment NPD

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1013339563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744620179",
            "telephone_number": "918-967-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622913",
            "telephone_number": "918-967-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHTON",
        "first_name": "KELSEY",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "BLOME",
            "credential": "P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haskell Regional Hospital, Inc.
• Haskell Regional Hospital, Inc.
• Haskell Regional Hospital, Inc.
• Haskell Regional Hospital, Inc.
• Haskell Regional Hospital, Inc.
• Heads Pharmacy Inc
• Healthback Home Health of Eastern Oklahoma, Inc.
• Healthflex, Inc.
• Lee Andrea Henderson
• William Henderson

• Physician Assistant in Stigler, OK
• Providers in Stigler, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.