Taylor Nicole Ely, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4660 Issued in OK

Practice address

1407 N Whisenant Dr
Duncan, OK 73533-1650

Phone

(580) 252-5300

NPI assigned

Oct 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Centurion Emergency Partners LLC

  • Emergency Medicine Physician
  • Duncan, OK
  • NPI 1750112942
  Medicare reassignment
• South Central Emergency Services PC

  • Emergency Medicine Physician
  • Stillwater, OK
  • NPI 1558663724
  Medicare reassignment

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1568125805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331650",
            "telephone_number": "580-252-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331650",
            "telephone_number": "580-252-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Wayne Edwards, O.D.
• Nathaniel David Edwards, OD
• William Louis Edwards, M.D.
• Thomas J Eiser, M.D.
• Stacie Herndon Elfrink, MD
• Molli Elizabeth Emerson, APRN FNP-C
• Robin Emerson, SLP
• Empire Public Schools
• Angela Tiana Essary, APNP, NP-C
• Shannon Evans, M.S., CCC-SLP

• Physician Assistant in Duncan, OK
• Providers in Duncan, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.