Individual provider Active NPI

Catherine Williams, P.A.-C

  • Physician Assistant
  • Catoosa, OK
National Provider Identifier
1366469959
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3081 Issued in OK
Practice address
1818 N Highway 66 Ste B
Catoosa, OK 74015-3052
Phone
(918) 379-5013
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5170 AZ
Physician Assistant 363A00000X
Physician Assistant 363A00000X 3081 OK Primary

Addresses

Primary practice location

1818 N Highway 66 Ste B
Catoosa, OK 74015-3052

Mailing address

1404 W Ulysses St
Broken Arrow, OK 74012-0509
Phone (773) 919-8407

Other practice location 1

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8400

Other practice location 2

11717 S Memorial Dr
Bixby, OK 74008-2027
Phone (918) 369-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX, GA, OK4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20090409000356 AR Practitioner - Physician Assistant 8224083795 Reassigns benefits to 1 organization
I20190626001190 TX Practitioner - Physician Assistant 8224083795 Reassigns benefits to 2 organizations
I20201215000165 GA Practitioner - Physician Assistant 8224083795 Reassigns benefits to 2 organizations
I20210922002101 OK Practitioner - Physician Assistant 8224083795 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1220 Caroline St NE
Suite a 230
Atlanta, GA 30307-2749
Phone (678) 710-3980

1436 Hwy 16 W
Griffin, GA 30223-2055
Phone (770) 889-1211

1480 Baxter St
Suite a
Athens, GA 30606-6393
Phone (706) 543-0228

209 Cooley Dr
Suite 101
Villa Rica, GA 30180-7057
Phone (770) 456-0911

2768 Watson Blvd
Suite 100
Centerville, GA 31028-1241
Phone (478) 302-0001

3425 Buford Dr
Suite 200
Buford, GA 30519-8785
Phone (678) 546-0200

3720 Holcomb Bridge Rd
Norcross, GA 30092-4795
Phone (770) 263-1000

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2804
Phone (770) 222-8900

3991 Hwy 78 W
Snellville, GA 30039-3929
Phone (678) 786-8677

4400 Peachtree Rd NE
Brookhaven, GA 30319-2729
Phone (404) 814-9199

4837 Bill Gardner Pkwy
Suite B
Locust Grove, GA 30248-3644
Phone (678) 800-1602

5419 Chamblee Dunwoody Rd
Dunwoody, GA 30338-4101
Phone (678) 284-2067

6000 Hillandale Dr
Lithonia, GA 30058-4858
Phone (770) 461-3776

782 Sr
Suite 96
Bonaire, GA 31005-9999
Phone (478) 273-3065

823 Loganville Hwy
Bethlehem, GA 30620-1709
Phone (470) 866-2396

995 Gaines School Rd
Athens, GA 30605-3133
Phone (706) 389-5677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3081OKMDProfessional Counselor
5170AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
St Vincent Infirmary Medical Center CurrentSince Jan 1, 2016 Accepting new patients
True North Health Navigation LLC CurrentSince Oct 26, 2023 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 12, 2019 Accepting new patients
St. Vincent Infirmary Medical Center CurrentSince Jan 1, 2016 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 12, 2019 Accepting new patients
Illiana Emergency Physicians, LLP Physician Assistant Past Accepting new patients
Illiana Emergency Physicians LLP Past Accepting new patients

Locations

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

2525 NW Expressway St
Ste 102
Oklahoma City, OK 73112
Phone (405) 213-0190

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1366469959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 W ULYSSES ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120509",
            "telephone_number": "773-919-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N HIGHWAY 66 STE B",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740153052",
            "telephone_number": "918-379-5013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235318",
            "country_code": "US",
            "telephone_number": "270-798-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11717 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Bixby",
            "state": "OK",
            "postal_code": "740082027",
            "country_code": "US",
            "telephone_number": "918-369-9555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CATHERINE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5170",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catoosa, OK

Sources for this page

Verify at the official NPI Registry.