Individual provider Active NPI

Sandra Kay Harryman, P.A.

  • Physician Assistant
  • Bartlesville, OK
National Provider Identifier
1023071156
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
989 Issued in OK
Practice address
3400 S.E. Frank Phillips
Ste 502
Bartlesville, OK 74006-2495
Phone
(918) 331-2577
Fax
(918) 331-2513
NPI assigned
Apr 10, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 989 OK Primary
Physician Assistant 363A00000X 1500323 KS
Physician Assistant 363A00000X 15-00323 KS

Addresses

Primary practice location

3400 S.E. Frank Phillips
Ste 502
Bartlesville, OK 74006-2495

Mailing address

3400 S.E. Frank Phillips
Ste 502
Bartlesville, OK 74006-2495
Phone (918) 331-2577

Other identifiers 2

IdentifierTypeStateIssuer
10003240CMedicaidKS
100193360AMedicaidOK

Other names 1

  • Sandra Kay Gonzalez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-00323KSMDPhysician Assistant
1500323KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Past Accepting new patients
Blue Stem Cardiology PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sandra.harryman@direct.stjohnhealthsystem.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1023071156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S.E. FRANK PHILLIPS",
            "address_2": "STE 502",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062495",
            "telephone_number": "918-331-2577",
            "fax_number": "918-331-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S.E. FRANK PHILLIPS",
            "address_2": "STE 502",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062495",
            "telephone_number": "918-331-2577",
            "fax_number": "918-331-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRYMAN",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "989",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500323",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-00323",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10003240C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100193360A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "GONZALEZ",
            "middle_name": "KAY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.