Oklahoma Advanced Diabetes Care PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

OKLAHOMA ADVANCED DIABETES CARE PLLC

Practice address

1016 24TH Ave NW Ste 110
Norman, OK 73069-6542

Phone

(405) 467-2280

NPI assigned

Aug 7, 2025

Organization subpart

No

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

Authorized official

Name

Stephanie Porter, PA-CNPI 1366831455

Title

Owner/Managing Member

Phone

(405) 467-2280

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Porter, PA

  • Physician Assistant
  • Norman, OK
  • NPI 1366831455
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1053296129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 24TH AVE NW STE 110",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696542",
            "telephone_number": "405-467-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 24TH AVE NW STE 110",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696542",
            "telephone_number": "405-467-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA ADVANCED DIABETES CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "405-467-2280",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.