Individual provider Active NPI

Terry J Arnold, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1780681684
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1458 Issued in OK
Practice address
1516 South Yorktown Avenue
Tulsa, OK 74104-0000
Phone
(918) 712-8888
Fax
(918) 712-8892
NPI assigned
Jul 7, 2005
Last updated
Mar 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003295 GA
Physician Assistant 363A00000X 1458 OK Primary

Addresses

Primary practice location

1516 South Yorktown Avenue
Tulsa, OK 74104-0000

Mailing address

1516 South Yorktown Avenue
Tulsa, OK 74104-0000
Phone (918) 712-8888

Other identifiers 1

IdentifierTypeStateIssuer
1000000350BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003295GAMDPhysical Therapy Assistant
3295GAMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
David B Minor MD PC CurrentSince Mar 15, 2010 Accepting new patients
Sergio Marano O.D. Mark Grisar O.D. PC Past Accepting new patients

Locations

1516 S Yorktown Pl
Tulsa, OK 74104
Phone (918) 712-8888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1780681684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 SOUTH YORKTOWN AVENUE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741040000",
            "telephone_number": "918-712-8888",
            "fax_number": "918-712-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SOUTH YORKTOWN AVENUE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741040000",
            "telephone_number": "918-712-8888",
            "fax_number": "918-712-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "TERRY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003295",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000000350B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.