Active NPI
Jeremy Daniel Paysnoe
- Physician Assistant
- Tulsa, OK
National Provider Identifier
1477025740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3025
- Practice address
- 1515 N Harvard Ave Ste B
Tulsa, OK 74115-4904 - Phone
- (918) 388-1901
- NPI assigned
- Dec 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3025 | OK | Primary |
Addresses
Primary practice location
1515 N Harvard Ave Ste B
Tulsa, OK 74115-4904
Mailing address
5341 E 32ND PL
Tulsa, OK 74135-5204
Phone (405) 414-3937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631664000000",
"number": "1477025740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5341 E 32ND PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741355204",
"telephone_number": "405-414-3937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 N HARVARD AVE STE B",
"city": "TULSA",
"state": "OK",
"postal_code": "741154904",
"telephone_number": "918-388-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYSNOE",
"first_name": "JEREMY",
"middle_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-26",
"last_updated": "2021-09-15",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "3025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.