Stephen Vance Paul, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA770 Issued in OK

Practice address

20 12TH Ave NW
Ardmore, OK 73401-5722

Phone

(580) 223-3411

Fax

(580) 226-6213

NPI assigned

Jun 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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.

• Healdton Municipal Hospital (SNF)

  • Medicare Defined Swing Bed Hospital Unit
  • Healdton, OK
  • NPI 1437169489
  NPD (past)

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1659666428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "STEPHEN",
        "middle_name": "VANCE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA770",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Patrick
• Julie Patrick
• Shirley Janell Patrick, ASSOCIATES DEGREE
• Karen Beth Patterson
• John Thomas Paul, PA
• Jessica Pearce, CASE MANAGER
• Haley Lynn Peden
• Pediatric Dental Associates PC
• Dereck A. Peery, D.O.
• Devin Lynn Peery, ARNP

• Medical Physician Assistant in Ardmore, OK
• Providers in Ardmore, 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 Jun 9, 2011; 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.