NPIMap

Individual provider Active NPI

Andie Renee Whalen, PA-C

  • Medical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1710554894
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5046 Issued in OK
Practice address
800 NE 10TH St
Oklahoma City, OK 73104-5418
Phone
(405) 271-4700
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5046 OK Primary

Addresses

Primary practice location

800 NE 10TH St
Oklahoma City, OK 73104-5418

Mailing address

800 NE 10TH St
Oklahoma City, OK 73104-5418
Phone (405) 271-4700

Other names 1

  • Andie Mathieson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711003192 OK Practitioner - Physician Assistant 6901200492 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies HSP Oklahoma LLCGroup PAC ID 2163863341, 14 clinicians

Practice addresses (Care Compare)

5602 SW Lee Blvd
Lawton, OK 73505-9635
Phone (580) 531-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Jun 1, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Jun 1, 2023 Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

6744 NW Cache Rd
Lawton, OK 73505
Phone (580) 536-9355

701 Cedar Lake Blvd
Ste 120
Oklahoma City, OK 73114
Phone (405) 286-1170

Organizations & group practices 8

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 4

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1710554894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-271-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-271-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "ANDIE",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "5046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDIE",
            "last_name": "MATHIESON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.