Individual provider Active NPI

Stephanie R. Garrison, P.A.

  • Surgical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1124094446
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1522 Issued in OK
Practice address
4120 W Memorial Rd
Suite 300
Oklahoma City, OK 73120-9320
Phone
(405) 748-3300
Fax
(405) 749-1671
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1522 OK
Surgical Physician Assistant 363AS0400X 1522 OK Primary

Addresses

Primary practice location

4120 W Memorial Rd
Suite 300
Oklahoma City, OK 73120-9320

Mailing address

4120 W Memorial Rd
Suite 300
Oklahoma City, OK 73120-9320
Phone (405) 748-3300

Other names 1

  • Stephanie R. Hahn Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060508000520 OK Practitioner - Physician Assistant 1456369842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4200 W Memorial Rd
Oklahoma City, OK 73120-8378

4200 W Memorial Rd
Suite 708
Oklahoma City, OK 73120-9350
Phone (405) 749-7023

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1522OKMDMedical Physician Assistant
1522OKMDSurgical Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1124094446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209320",
            "telephone_number": "405-748-3300",
            "fax_number": "877-657-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209320",
            "telephone_number": "405-748-3300",
            "fax_number": "405-749-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "STEPHANIE",
        "middle_name": "R.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA1522",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HAHN",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.