Individual provider Active NPI

Nhanhien D Tran, PA-C

  • Physician Assistant
  • Wagoner, OK
National Provider Identifier
1518087865
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1501107 Issued in KS
Practice address
1317 S Dewey Ave
Wagoner, OK 74467-7013
Phone
(918) 485-9696
Fax
(918) 485-1701
NPI assigned
Mar 30, 2007
Last updated
Apr 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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 1501107 KS Primary

Addresses

Primary practice location

1317 S Dewey Ave
Wagoner, OK 74467-7013

Mailing address

509 NW 9TH St
Wagoner, OK 74467-2305
Phone (316) 516-4895

Other identifiers 3

IdentifierTypeStateIssuer
110990040OtherMEDICARE (VIA CHRIST)
OKB0019OtherOKMEDICARE GROUP PTAN
200739590AMedicaidKS

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
I20070723000007 OK Practitioner - Physician Assistant 5092751636 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1638OKMDPhysical Therapy Assistant
1501107KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Wellness Anadarko Inc CurrentSince Apr 21, 2024 Accepting new patients
Rha Stroud Inc Current Accepting new patients
Rural Wellness Fairfax Inc CurrentSince Apr 21, 2024 Accepting new patients
Runway Emergency Physicians LLC Past Accepting new patients
Tracey W. Childers, D.O. P.C. Past Accepting new patients

Locations

1002 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-2551

40 Hospital Rd
Fairfax, OK 74637
Phone (918) 642-8827

2308 W Highway 66
Stroud, OK 74079
Phone (918) 968-3571

Interoperability endpoints

  • Direct secure messaging: nhanhientran@rwhstroud.medalliesdirect.net

Organizations & group practices 7

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1518087865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 NW 9TH ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744672305",
            "telephone_number": "316-516-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 S DEWEY AVE",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744677013",
            "telephone_number": "918-485-9696",
            "fax_number": "918-485-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "NHANHIEN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (VIA CHRIST)",
            "identifier": "110990040",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "OKB0019",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200739590A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

Verify at the official NPI Registry.