Gary Scott Taggart, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1743 Issued in OK

Practice address

1373 E Boone St
Suite 3401
Tahlequah, OK 74464-3330

Phone

(918) 456-6848

Fax

(918) 456-1150

NPI assigned

Feb 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

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.

• Northeastern Health System

  • Emergency Medicine Physician
  • Tahlequah, OK
  • NPI 1457574170
  NPD (past)

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1447428537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 E BOONE ST",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643330",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 E BOONE ST",
            "address_2": "SUITE 3401",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643330",
            "telephone_number": "918-456-6848",
            "fax_number": "918-456-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGGART",
        "first_name": "GARY",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200204150 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Farhan Abul Syed, MD
• Sana Syed, M.D.
• T M Baker, OD Inc.
• Aubry Tackett
• Staci Lynn Tackett, PHARM D
• Tahlequah City Hospital
• Tahlequah Dental Care PLLC
• Tahlequah Drug Company LLC
• Tahlequah Family Medicine Clinic
• Tahlequah Family Vision Clinic, PLLC

• Surgical Physician Assistant in Tahlequah, OK
• Providers in Tahlequah, 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 Sep 27, 2012; 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.