Individual provider Active NPI

Haley Trimble, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1356171425
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5309 Issued in OK
Practice address
510 E Memorial Rd
Oklahoma City, OK 73114-2229
Phone
(405) 777-4726
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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 5309 OK Primary

Addresses

Primary practice location

510 E Memorial Rd
Oklahoma City, OK 73114-2229

Mailing address

704 Hedgewood Dr
Moore, OK 73160-8398
Phone (405) 905-9489

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
I20240920001999 OK Practitioner - Physician Assistant 2062953714 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Care Hospitalist Group PLLCGroup PAC ID 3779862446, 22 clinicians
Optimum Post Acute Care PLLCGroup PAC ID 5799162111, 18 clinicians
Midwest Hospitalist Group PLLCGroup PAC ID 9133465354, 18 clinicians

Practice addresses (Care Compare)

1 S Bryant Ave
Edmond, OK 73034-6309
Phone (405) 341-6100

1501 E 19TH St
Edmond, OK 73013-6618
Phone (405) 914-2356

2825 Parklawn Dr
Midwest City, OK 73110-4201
Phone (405) 245-1453

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5309OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Care Hospitalist Group PLLC CurrentSince Dec 29, 2025 Accepting new patients

Locations

1 S Bryant Ave
Edmond, OK 73034
Phone (405) 341-6100

1501 E 19th St
Edmond, OK 73013
Phone (405) 348-6611

1104 E State Highway 152
#1
Mustang, OK 73064
Phone (405) 376-9544

Interoperability endpoints

  • Direct secure messaging: htrimble522310@direct-ehr-ssmhc.com

Organizations & group practices 4

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 2

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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1356171425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 HEDGEWOOD DR",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731608398",
            "telephone_number": "405-905-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142229",
            "telephone_number": "405-777-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBLE",
        "first_name": "HALEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.