Jackie J Parnell, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

552 Issued in OK

Practice address

607 S Broadway
Coweta, OK 74429-5000

Phone

(918) 486-5564

Fax

(918) 486-3284

NPI assigned

Oct 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Midwest Hospitalists Services PLLC

  • Hospitalist Physician
  • Tahlequah, OK
  • NPI 1023098936
  NPD (past)
• Prophylaxis Healthcare LLC

  • Multi-Specialty Clinic/Center
  • Bixby, OK
  • NPI 1538453923
  NPD (past)
• Tracey W. Childers, D.O. P.C.

  • Otolaryngology Physician
  • Tahlequah, OK
  • NPI 1720274699
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1639169337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15187 W GRANDVIEW RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744641118",
            "telephone_number": "918-316-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S BROADWAY",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744295000",
            "telephone_number": "918-486-5564",
            "fax_number": "918-486-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNELL",
        "first_name": "JACKIE",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100209620B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Opco Coweta, Ok, LLC
• Osu Center for Health Sciences
• Jill Leigh Overhuls
• Sandra Parke, AU D
• Barry Ray Parkerson
• Johnathan W Peck, DMS, PA-C
• Kala Perez, M.S. M.ED.
• Ashley Anne Petersen, M.D.
• Kasey Pierce, PHARMD
• Dejuan Powell

• Medical Physician Assistant in Coweta, OK
• Providers in Coweta, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.