Individual provider Active NPI

Janet Y Parker, PA

  • Physician Assistant
  • Weleetka, OK
National Provider Identifier
1720124472
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA188 Issued in OK
Practice address
315 W. 9TH
Weleetka, OK 74880
Phone
(405) 786-2248
Fax
(405) 786-2006
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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 PA188 OK Primary

Addresses

Primary practice location

315 W. 9TH
Weleetka, OK 74880

Mailing address

PO Box 337
Weleetka, OK 74880-0337
Phone (405) 786-2248

Other identifiers 1

IdentifierTypeStateIssuer
100135680AMedicaidOK

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
I20130726000520 OK Order and Referring Only - Physician Assistant 0840322376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA188OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Clinic of Weleetka CurrentSince Jul 13, 2010 Accepting new patients
Sanderson Health Center LLC PastSince Dec 21, 2025 Accepting new patients

Locations

315 W 9th St
Weleetka, OK 74880
Phone (405) 786-2248

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Clinic of WeleetkaWeleetka, OK, CCN 373819 Rural health clinic General Partnership Interest Jul 13, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1720124472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "WELEETKA",
            "state": "OK",
            "postal_code": "748800337",
            "telephone_number": "405-786-2248",
            "fax_number": "405-786-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W. 9TH",
            "city": "WELEETKA",
            "state": "OK",
            "postal_code": "74880",
            "telephone_number": "405-786-2248",
            "fax_number": "405-786-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JANET",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100135680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weleetka, OK

Sources for this page

Verify at the official NPI Registry.