Diana Anderson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA3111 Issued in OK

Practice address

920 Stanton L Young Blvd Ste 2040
Oklahoma City, OK 73104-5036

Phone

(405) 271-4113

NPI assigned

Nov 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Diana Wiley Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Board of Regents of the University of Oklahoma - Ou Physicians

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1801869250
  Medicare reassignment NPD
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Ou Health Partners, Inc

  dba Ou Health Partners

  • Multi-Specialty Clinic/Center
  • Oklahoma City, OK
  • NPI 1528642642
  Medicare reassignment
• Board of Regents of the University of Oklahoma - Ou Physicians

  • Multi-Specialty Clinic/Center
  • Edmond, OK
  • NPI 1124646971
  NPD
• Ou Health Partners, Inc

  dba OUHP Orthotics & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Oklahoma City, OK
  • NPI 1447834460
  NPD

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1740824630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD STE 2040",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD STE 2040",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045036",
            "telephone_number": "405-271-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA3111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "WILEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Charles Anderson, PHARMD
• Briana Anderson, M.ED
• Carol Jean Anderson, MHR, LPC
• Charles A Anderson, CP
• Christopher D Anderson, B.A.
• Dina Anderson, OTR/L
• Donald Anderson, LCSW
• Emily Anderson, NCSP
• Eric Hilton Anderson
• Gabrielle Anderson

• Medical Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, 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 Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.