Individual provider Active NPI

Ashley Nichole McKoy, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1568827426
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2612 Issued in OK
Practice address
1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243
Phone
(918) 592-0999
NPI assigned
Dec 20, 2015
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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 2612 OK Primary

Addresses

Primary practice location

1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243

Mailing address

1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243
Phone (918) 592-0999

Other names 1

  • Ashley Nichole Cornett Former name

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
I20160304000678 OK Practitioner - Physician Assistant 7911203757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Suite 100
Owasso, OK 74055-6638
Phone (918) 376-8400

1265 S Utica Ave
Tulsa, OK 74104-4243

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2612OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: acornett112791@ahs.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1450569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1568827426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 S UTICA AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S UTICA AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY",
        "first_name": "ASHLEY",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-20",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "CORNETT",
            "middle_name": "NICHOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.