Individual provider Active NPI

Valerie Ann Stockton, P.A.

  • Physician Assistant
  • Edmond, OK
National Provider Identifier
1811995947
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
839 Issued in OK
Practice address
1714 S Kelly Ave
Edmond, OK 73013-3624
Phone
(405) 216-3993
Fax
(405) 513-7343
NPI assigned
Jul 12, 2005
Last updated
Jun 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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 839 OK Primary

Addresses

Primary practice location

1714 S Kelly Ave
Edmond, OK 73013-3624

Mailing address

1714 S Kelly Ave
Edmond, OK 73013-3624
Phone (405) 216-3993

Other identifiers 1

IdentifierTypeStateIssuer
200016920BMedicaidOK

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
I20080313000477 OK Practitioner - Physician Assistant 7517042609 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
839OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Sep 10, 2018 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients
Edmond Am Clinic LLC PastSince Mar 25, 2012 Accepting new patients

Locations

1200 Childrens Ave
#8C
Oklahoma City, OK 73104
Phone (405) 271-2662

1200 Childrens Ave
Ste 8C
Oklahoma City, OK 73104
Phone (405) 271-2655

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 5

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1811995947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 S KELLY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133624",
            "telephone_number": "405-216-3993",
            "fax_number": "405-513-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 S KELLY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133624",
            "telephone_number": "405-216-3993",
            "fax_number": "405-513-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "VALERIE",
        "middle_name": "ANN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200016920B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.