Individual provider Active NPI

Tammie D Reggio, P.A.

  • Physician Assistant
  • Mustang, OK
National Provider Identifier
1386619856
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
981 Issued in OK
Practice address
160 E SW 59TH St
Mustang, OK 73064-4722
Phone
(405) 757-7818
Fax
(405) 703-0645
NPI assigned
Feb 20, 2006
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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 981 OK Primary
Medical Physician Assistant 363AM0700X 981 OK
Emergency Medicine Physician 207P00000X 981 OK

Addresses

Primary practice location

160 E SW 59TH St
Mustang, OK 73064-4722

Mailing address

4300 Caravel Dr Apt 1115
Yukon, OK 73099-3782
Phone (580) 716-0245

Other practice location 1

14101 N Eastern Ave Ste B
Edmond, OK 73013-5860
Phone (888) 245-9806

Other practice location 2

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 930-4965

Other practice location 3

105 E Grand Ave
Tonkawa, OK 74653-3503
Phone (580) 789-1268

Other identifiers 1

IdentifierTypeStateIssuer
100227880AMedicaidOK

Other names 1

  • Tammie D Maness 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
I20040727001120 OK Practitioner - Physician Assistant 0345210431 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
981OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Jun 12, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Jun 12, 2023 Accepting new patients
Ohh Physicians, LLC Past Accepting new patients
Jeffrey R Shuart MD PC PastSince Oct 1, 1996 Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

2501 N 14th St
Ponca City, OK 74601
Phone (580) 749-5076

Interoperability endpoints

  • FHIR API: https://epicrp.okheart.com/Oauth2Proxy/MYCHART/api/FHIR/R4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/I-7_h5bO8aC4DcrZl24eCXsg8gA1KGV3/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1386619856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CARAVEL DR APT 1115",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993782",
            "telephone_number": "580-716-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E SW 59TH ST",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730644722",
            "telephone_number": "405-757-7818",
            "fax_number": "405-703-0645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14101 N Eastern Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730135860",
            "country_code": "US",
            "telephone_number": "888-245-9806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4913 W Reno Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731276339",
            "country_code": "US",
            "telephone_number": "405-930-4965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Tonkawa",
            "state": "OK",
            "postal_code": "746533503",
            "country_code": "US",
            "telephone_number": "580-789-1268",
            "fax_number": "888-712-9476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGGIO",
        "first_name": "TAMMIE",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "981",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "981",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "981",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100227880A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMIE",
            "last_name": "MANESS",
            "middle_name": "D",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mustang, OK

Sources for this page

Verify at the official NPI Registry.