NPIMap

Individual provider Active NPI

Gavin C Christie, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1083685630
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1170 Issued in OK
Practice address
3366 NW Expressway Ste 250
Oklahoma City, OK 73112-4427
Phone
(405) 552-0401
Fax
(405) 848-3210
NPI assigned
Jan 31, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1170 OK Primary

Addresses

Primary practice location

3366 NW Expressway Ste 250
Oklahoma City, OK 73112-4427

Mailing address

5300 N Independence Ave
280
Oklahoma City, OK 73112-5556
Phone (405) 552-0401

Other identifiers 1

IdentifierTypeStateIssuer
100167880AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000476 OK Practitioner - Physician Assistant 5193738409 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1110 N Lee Ave
Oklahoma City, OK 73103-2612

13401 N Western Ave
Suite 302
Oklahoma City, OK 73114-1411
Phone (405) 272-6685

608 NW 9TH St
Oklahoma City, OK 73102-1049

828 SW 4TH St
Moore, OK 73160-2413
Phone (405) 799-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1170OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Express, LLP CurrentSince Mar 19, 2024 Accepting new patients
Stillwater Medical Center Authority CurrentSince Oct 15, 2024 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 19, 2024 Accepting new patients
Stillwater Medical Center Authority Physician Assistant CurrentSince Oct 15, 2024 Accepting new patients
Healthcare Express, LLP CurrentSince Mar 19, 2024 Accepting new patients
Terrell R Phillips DO Inc PastSince Jun 7, 2020 Accepting new patients
Stillwater Medical Center Physicians Past Accepting new patients
Summit Medical Center Past Accepting new patients
Surgical Specialists of Oklahoma PLLC Past Accepting new patients

Locations

1701 S Douglas Blvd
Oklahoma City, OK 73130
Phone (405) 302-8999

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

3515 Richmond Rd
Texarkana, TX 75503
Phone (903) 831-7270

Interoperability endpoints

  • Direct secure messaging: gavin.christie.p1@direct.smc.nextgenshare.com
  • Direct secure messaging: gchristie@direct.uspi.com
  • Direct secure messaging: gchristie15065@direct.integrisok.com
  • Direct secure messaging: gchristie526800@direct-ehr-ssmhc.com

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083685630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-552-0401",
            "fax_number": "405-848-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY STE 250",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124427",
            "telephone_number": "405-552-0401",
            "fax_number": "405-848-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "GAVIN",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100167880A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.