Jessica Laura Graves, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2129 Issued in OK

Practice address

4700 W Urbana St Ste 100
Broken Arrow, OK 74012-5520

Phone

(539) 281-3101

NPI assigned

Feb 29, 2012

Last updated

May 18, 2026By 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 2

Addresses

Other names 1

• Jessica Laura Brennan Former name

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

Specialty

Physician Assistant

Education

University of Oklahoma College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southside Dermatology PLLCGroup PAC ID 9234487554, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BFBBED/Endpoint/BFBBED

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.

• Restore Dermatology Clinic LLC

  • Dermatology Physician
  • Broken Arrow, OK
  • NPI 1336002302
  Medicare reassignment NPD Authorized official
• Southside Dermatology PLLC

  • Dermatology Physician
  • Tulsa, OK
  • NPI 1750877072
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  Care Compare affiliation
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1407120066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 W URBANA ST STE 100",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125520",
            "telephone_number": "539-281-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W URBANA ST STE 100",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125520",
            "telephone_number": "539-281-3101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 S 38th St Ste E",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744014937",
            "country_code": "US",
            "telephone_number": "918-840-5276",
            "fax_number": "918-877-1312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 E Kaahumanu Ave",
            "address_purpose": "LOCATION",
            "city": "Kahului",
            "state": "HI",
            "postal_code": "967322118",
            "country_code": "US",
            "telephone_number": "808-871-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "JESSICA",
        "middle_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-770",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA2129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BRENNAN",
            "middle_name": "LAURA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn M Grace, M.S. CCC-SLP
• Betsy Jean Graham-Moeller, APRN, FNP
• Ashlee M Graham, PA-C, CAQ PSYCH
• Jamel Paul Grant, B.A
• Ann Caroline Graves
• Hannah Grace Gray, COTA/L
• Kerry Gray
• Karie Renee Graybill
• Green Country Counseling PLLC
• Green Country Infectious Disease PC

• Medical Physician Assistant in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.