Individual provider Active NPI

Katie Leigh Elliott, CSFA

  • Surgical Physician Assistant
  • Broken Arrow, OK
National Provider Identifier
1619265212
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
7301 E Nashville St
Broken Arrow, OK 74014
Phone
(918) 595-2331
NPI assigned
Jul 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

7301 E Nashville St
Broken Arrow, OK 74014

Mailing address

7301 E Nashville St
Broken Arrow, OK 74014-2980
Phone (918) 595-2331

Other practice location 1

6313 E Commercial St
Broken Arrow, OK 74014-6981
Phone (918) 595-2331

Other practice location 2

6313 E Commercial St
Broken Arrow, OK 74014-6981
Phone (918) 595-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kle Surgical Assisting, LLC Surgical Past Accepting new patients
A Cut Above Surgical Assisting LLC Surgical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1619265212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 E NASHVILLE ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740142980",
            "telephone_number": "918-595-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 E NASHVILLE ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74014",
            "telephone_number": "918-595-2331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6313 E Commercial St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740146981",
            "country_code": "US",
            "telephone_number": "918-595-2331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6313 E Commercial St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740146981",
            "country_code": "US",
            "telephone_number": "918-595-2331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KATIE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-16",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.