Individual provider Active NPI

Stephanie Jane Garrett, PA-C

  • Physician Assistant
  • Porter, OK
National Provider Identifier
1821482811
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2481 Issued in OK
Practice address
505 S Main St
Porter, OK 74454-1015
Phone
(918) 483-0111
Fax
(918) 483-4174
NPI assigned
Mar 27, 2015
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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 2481 OK Primary

Addresses

Primary practice location

505 S Main St
Porter, OK 74454-1015

Mailing address

505 S Main St
Porter, OK 74454-1015
Phone (918) 483-0111

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
I20151019000551 OK Practitioner - Physician Assistant 2769791565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 N 32ND St
Muskogee, OK 74401-2104
Phone (918) 912-2333

505 S Main St
Porter, OK 74454-1015
Phone (918) 483-0111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Verdigris Valley Health Centers, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients

Locations

607 S Broadway
Coweta, OK 74429
Phone (918) 279-6675

110 W Martin Luther King St
Muskogee, OK 74401
Phone (918) 483-0111

201 N 32nd St
Muskogee, OK 74401
Phone (918) 912-2333

619 N Main St
Muskogee, OK 74401
Phone (918) 687-1039

505 S Main St
Tullahassee, OK 74454
Phone (918) 483-0111

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1821482811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "city": "PORTER",
            "state": "OK",
            "postal_code": "744541015",
            "telephone_number": "918-483-0111",
            "fax_number": "918-483-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "city": "PORTER",
            "state": "OK",
            "postal_code": "744541015",
            "telephone_number": "918-483-0111",
            "fax_number": "918-483-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "STEPHANIE",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porter, OK

Sources for this page

Verify at the official NPI Registry.