Jennifer Alexis Gonzales, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1152 Issued in OK

Practice address

6802 S Olympia Ave
Ste300
Tulsa, OK 74132-1823

Phone

(918) 749-0762

Fax

(918) 744-4246

NPI assigned

Apr 6, 2006

Last updated

Jul 13, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1366404030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-749-0762",
            "fax_number": "918-744-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "STE300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-749-0762",
            "fax_number": "918-744-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JENNIFER",
        "middle_name": "ALEXIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "PA1152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niki Gondola
• Rachel Gonshor
• Anne Marie Gonzales, LCSW
• Cathlene Renee Gonzales
• Isabel Gonzales
• Kelsey Gonzales
• Kiera Mercadies Gonzales
• Miranda Rae Gonzales
• Raymond Lee Gonzales, CMA-I, CNA, HHA,DDCA
• Chayanne Gonzalez - Seda

• Surgical Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Surgical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.