Individual provider Active NPI

Natalie Anne Ciavolino, PA-C

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1598545956
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
220 S Van Buren St
Enid, OK 73703-5812
Phone
(580) 234-9355
NPI assigned
Oct 3, 2023
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 NU Primary

Addresses

Primary practice location

220 S Van Buren St
Enid, OK 73703-5812

Mailing address

1120 N Cleveland St Apt 5206
Enid, OK 73703-3218
Phone (240) 587-1768

Other names 1

  • Natalie Anne Deems 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
I20231127003210 OK Practitioner - Physician Assistant 0749638039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 S Division St
Xpress Wellness Urgent Care
Guthrie, OK 73044-5021
Phone (405) 293-4504

1327 Oklahoma Ave
Woodward, OK 73801-4454
Phone (580) 254-2377

220 S Van Buren St
Xpress Wellness Urgent Care
Enid, OK 73703-5812
Phone (580) 234-9355

2501 N 14TH St
Xpress Wellness Urgent Care
Ponca City, OK 74601-1734
Phone (580) 749-5076

2525 Chandler Rd
Muskogee, OK 74403-5088
Phone (918) 681-7533

4475 E Waterloo Rd
Edmond, OK 73034-9200
Phone (405) 531-3835

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5139OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Nov 6, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Nov 6, 2023 Accepting new patients
Williams Medical Group Practice, LLC Past Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

Organizations & group practices 3

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": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1598545956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N CLEVELAND ST APT 5206",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033218",
            "telephone_number": "240-587-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035812",
            "telephone_number": "580-234-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAVOLINO",
        "first_name": "NATALIE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "DEEMS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.