William Christopher Petty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5058 Issued in OK

Practice address

4301 Wilson St
Fort Sill, OK 73503-4472

Phone

(580) 558-2635

Fax

(580) 558-2314

NPI assigned

Nov 14, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1700355237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2635",
            "fax_number": "580-558-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2635",
            "fax_number": "580-558-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "WILLIAM",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA IDENTIFICATION NUMBER",
            "identifier": "1158126",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Payton, RN
• Bonnie L Pendleton, AU.D., M.S., M.A.
• Tabatha Pepin, FNP
• Carmen A Percival, PA-C
• Ashley Nicole Perez, FNP-C
• Timothy W Phelps, LMFT, LADC
• Dana Marie Phillips, REGISTERED NURSE
• Gary Leon Pina, PT, DPT
• Amanda Podunavac, RDH
• Latifah Serita Porter

• Physician Assistant in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.