Individual provider Active NPI

Rebecca R Williams, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1487661245
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1290 Issued in OK
Practice address
4505 Memorial Cir
Oklahoma City, OK 73142-5004
Phone
(405) 749-7099
Fax
(405) 216-5872
NPI assigned
Aug 2, 2006
Last updated
Nov 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1290 OK Primary

Addresses

Primary practice location

4505 Memorial Cir
Oklahoma City, OK 73142-5004

Mailing address

530 N Monte Vista St
Suite a
Ada, OK 74820-4675
Phone (580) 436-7101

Other identifiers 1

IdentifierTypeStateIssuer
1290OtherOKPHYSICIAN ASSISTANTS

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
I20050506000027 OK Practitioner - Physician Assistant 0345294153 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Quick Urgent Care LLCGroup PAC ID 4486937505, 9 clinicians

Practice addresses (Care Compare)

2212 N Broadway St
Moore, OK 73160-4303
Phone (405) 285-7222

2252 N Broadway St
Moore, OK 73160-4303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1290OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Classen Urgent Care Clinic LLC CurrentSince Sep 1, 2014 Accepting new patients
Mercy Access LLC Past Accepting new patients
Superior Family Care, LLC PastSince Mar 17, 2024 Accepting new patients

Locations

2818 Classen Blvd
Norman, OK 73071
Phone (405) 701-7111

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1487661245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MONTE VISTA ST",
            "address_2": "SUITE A",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204675",
            "telephone_number": "580-436-7101",
            "fax_number": "580-436-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 MEMORIAL CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731425004",
            "telephone_number": "405-749-7099",
            "fax_number": "405-216-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "REBECCA",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANTS",
            "identifier": "1290",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.