Active NPI
Steven Dale Qualls, P.A.
- Physician Assistant
- Oklahoma City, OK
National Provider Identifier
1508949314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 730
- Practice address
- 9600 Broadway Ext
Oklahoma City, OK 73114-7408 - Phone
- (405) 486-2445
- Fax
- (405) 486-2451
- NPI assigned
- Oct 23, 2006
- 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 | 730 | OK | Primary |
Addresses
Primary practice location
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Mailing address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 486-2445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 730 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul Francel, MD, PC | Past | Accepting new patients | |
| Parkview Hospital | Past | Accepting new patients |
Organizations & group practices 4
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.
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- NPI 1659413649
-
- Emergency Medicine Physician
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- NPI 1114239795
-
- General Acute Care Hospital
- El Reno, OK
- NPI 1821087065
-
- Neurological Surgery Physician
- Oklahoma City, OK
- NPI 1184808099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398211200000",
"number": "1508949314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9600 BROADWAY EXT",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731147408",
"telephone_number": "405-486-2445",
"fax_number": "405-486-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 BROADWAY EXT",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731147408",
"telephone_number": "405-486-2445",
"fax_number": "405-486-2451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUALLS",
"first_name": "STEVEN",
"middle_name": "DALE",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2014-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.