Individual provider Active NPI

Kadilyn Hourigan, PA

  • Physician Assistant
  • Claremore, OK
National Provider Identifier
1790108132
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2368 Issued in OK
Practice address
2990 N Sioux Ave
Claremore, OK 74017-3700
Phone
(918) 342-2622
Fax
(918) 342-2641
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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 2368 OK Primary

Addresses

Primary practice location

2990 N Sioux Ave
Claremore, OK 74017-3700

Mailing address

2990 N Sioux Ave
Claremore, OK 74017-3700
Phone (918) 342-2622

Other identifiers 1

IdentifierTypeStateIssuer
2368OtherOKLICENSE

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
I20140417000165 OK Practitioner - Physician Assistant 4385876721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Green Country Behavioral Health Services, Inc.Group PAC ID 8022019017, 14 clinicians

Practice addresses (Care Compare)

619 N Main St
Muskogee, OK 74401-4431
Phone (918) 682-8407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2368OKMDPhysical Therapy Assistant

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": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1790108132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 N SIOUX AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173700",
            "telephone_number": "918-342-2622",
            "fax_number": "918-342-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N SIOUX AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173700",
            "telephone_number": "918-342-2622",
            "fax_number": "918-342-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOURIGAN",
        "first_name": "KADILYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2368",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.