Individual provider Active NPI

Sarah Cloughly, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1053721142
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2517 Issued in OK
Practice address
7807 S Walker Ave
Oklahoma City, OK 73139-9470
Phone
(405) 636-0767
Fax
(405) 636-0353
NPI assigned
Apr 29, 2014
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51534 CA
Physician Assistant 363A00000X 2517 OK Primary

Addresses

Primary practice location

7807 S Walker Ave
Oklahoma City, OK 73139-9470

Mailing address

7807 S Walker Ave
Oklahoma City, OK 73139-9470
Phone (405) 636-0767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20211129002402 TX Practitioner - Physician Assistant 2466764824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

18310 W Airport Blvd
100 Afc Urgent Care
Richmond, TX 77407-5032
Phone (832) 551-3503

6445 FM 1463 Rd
Suite 230
Katy, TX 77494-4031
Phone (281) 990-6890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51534CAMDPharmacist
2517OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Vernon C Sorenson MD Inc. PastSince Jul 1, 2013 Accepting new patients
Summit Medical Center Past Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients
Bakersfield Emergency Medical Corp. Past Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Interoperability endpoints

  • Direct secure messaging: sarah.cloughly@166622370791428.direct.elationemr.com

Organizations & group practices 6

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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1053721142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7807 S WALKER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399470",
            "telephone_number": "405-636-0767",
            "fax_number": "405-636-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 S WALKER AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399470",
            "telephone_number": "405-636-0767",
            "fax_number": "405-636-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUGHLY",
        "first_name": "SARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51534",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.