Individual provider Active NPI

Heather Raye Taylor

  • Physician Assistant
  • Fort Gibson, OK
National Provider Identifier
1649149998
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5793 Issued in OK
Practice address
108 Lone Oak Cir
Fort Gibson, OK 74434-5001
Phone
(918) 478-6005
Fax
(918) 478-6020
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 5793 OK Primary

Addresses

Primary practice location

108 Lone Oak Cir
Fort Gibson, OK 74434-5001

Mailing address

802 Cromwell PL
Muskogee, OK 74403-2130
Phone (214) 538-1625

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
I20260331000176 OK Practitioner - Physician Assistant 8325523160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

108 Lone Oak Cir
Fort Gibson, OK 74434-5001
Phone (918) 478-6005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

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": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1649149998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 CROMWELL PL",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744032130",
            "telephone_number": "214-538-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LONE OAK CIR",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744345001",
            "telephone_number": "918-478-6005",
            "fax_number": "918-478-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "HEATHER",
        "middle_name": "RAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gibson, OK

Sources for this page

Verify at the official NPI Registry.