Destiny Etter

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

405 S Oklahoma Ave
Cherokee, OK 73728-2545

Phone

(580) 596-2800

Fax

(580) 596-2805

NPI assigned

Aug 5, 2021

Sex

Female

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

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Salt Plains Health Center IncGroup PAC ID 9133201171, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016
• St Mary'S Regional Medical Center Hospital, Enid, OK, CCN 370026

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.

• Great Salt Plains Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cherokee, OK
  • NPI 1881876738
  Medicare reassignment Care Compare group
• Great Salt Plains Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Enid, OK
  • NPI 1699564476
  NPD
• Integris Bass Baptist Health Center

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1144236571
  NPD (past)
• Uhs of Oklahoma, LLC

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1417947466
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Integris Bass Baptist Health Center

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1144236571
  Care Compare affiliation
• Uhs of Oklahoma, LLC

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1417947466
  Care Compare affiliation

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1770257537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 17TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S OKLAHOMA AVE",
            "city": "CHEROKEE",
            "state": "OK",
            "postal_code": "737282545",
            "telephone_number": "580-596-2800",
            "fax_number": "580-596-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTER",
        "first_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bass Memorial Baptist Hospital
• Kerri Bell, MS
• Caring Company
• Carl W. Newton, O D, P C
• Cherokee Public Schools
• Keenan L Ferguson, D.O.
• Brandi K Fulgham, MCP, LPC
• Leva Darryle Gibson, DDS
• Grace DPC
• Great Salt Plains Health Center

• Physician Assistant in Cherokee, OK
• Providers in Cherokee, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.