Charlene Elaine Reust, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2549 Issued in OK

Practice address

1084 Nickerson St
Waynoka, OK 73860

Phone

(580) 824-2291

Fax

(580) 824-0429

NPI assigned

Jun 16, 2005

Reactivated

Mar 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Specialty

Physician Assistant

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
• Share Medical Center Hospital, Alva, OK, CCN 371341
• Integris Health Woodward Hospital Hospital, Woodward, OK, CCN 370002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: creust165094@direct.integrisok.com

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

• Alva Hospital Authority

  dba Share Medical Center

  • Critical Access Hospital
  • Alva, OK
  • NPI 1679684682
  Care Compare affiliation
• Integris Bass Baptist Health Center

  dba Integris Health Enid Hospital

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1144236571
  Care Compare affiliation
• Integris Health Woodward Hospital Inc

  dba Integris Health Woodward Hospital

  • General Acute Care Hospital
  • Woodward, OK
  • NPI 1558148627
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1588669428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "580-824-2291",
            "fax_number": "580-824-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 NICKERSON ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "73860",
            "telephone_number": "580-824-2291",
            "fax_number": "580-824-0429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738014454",
            "country_code": "US",
            "telephone_number": "580-254-2377",
            "fax_number": "580-254-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REUST",
        "first_name": "CHARLENE",
        "middle_name": "ELAINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2018-10-17",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1500390",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2549",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "426724",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100287510F",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100287510D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Louise McClain, BS
• Dianna Lea Meade
• Linda Ialene Mouser
• Northwest Treatment Center
• Alina Jade Opferman
• Kristen Leigh Ross
• Shonda Russell
• Jeffery S Schwerdtfeger, PA-C
• Lois Arleta Smith
• Bethany S Stout, LADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.