Individual provider Active NPI

Landon James Nault, PA-C

  • Medical Physician Assistant
  • Enid, OK
National Provider Identifier
1851056758
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4667 Issued in OK
Practice address
900 W Cherokee Ave
Enid, OK 73701-5410
Phone
(580) 233-6707
Fax
(580) 233-3724
NPI assigned
Nov 4, 2021
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4667 OK
Medical Physician Assistant 363AM0700X 4667 OK Primary
Surgical Physician Assistant 363AS0400X 4667 OK

Addresses

Primary practice location

900 W Cherokee Ave
Enid, OK 73701-5410

Mailing address

1101 Sawgrass LN
Enid, OK 73703-7056
Phone (405) 368-5852

Other practice location 1

207 E F St
Okeene, OK 73763-9441
Phone (580) 822-4417

Other practice location 2

4900 Oklahoma Ave
Woodward, OK 73801-3719
Phone (580) 254-5316

Other identifiers 1

IdentifierTypeStateIssuer
201061880AMedicaidOK

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
I20220419001704 OK Practitioner - Physician Assistant 7416344593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Oklahoma Orthopaedic Clinic PCGroup PAC ID 3870584931, 9 clinicians

Practice addresses (Care Compare)

900 W Cherokee Ave
Enid, OK 73701-5410
Phone (580) 233-6707

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.74 of 100Reported as group
Quality
68.62
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4667OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Okeene Municipal Hospital and Schallmo Authority CurrentSince Jan 1, 2022 Accepting new patients
Okeene Municipal Hospital and Schallmo Authority CurrentSince Jan 1, 2022 Accepting new patients

Locations

207 E F St
Okeene, OK 73763
Phone (580) 822-4321

Interoperability endpoints

  • Direct secure messaging: lnault409462@direct-ehr-ssmhc.com

Organizations & group practices 3

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1851056758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAWGRASS LN",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737037056",
            "telephone_number": "405-368-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W CHEROKEE AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015410",
            "telephone_number": "580-233-6707",
            "fax_number": "580-233-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 E F St",
            "address_purpose": "LOCATION",
            "city": "Okeene",
            "state": "OK",
            "postal_code": "737639441",
            "country_code": "US",
            "telephone_number": "580-822-4417",
            "fax_number": "580-822-3018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738013719",
            "country_code": "US",
            "telephone_number": "580-254-5316",
            "fax_number": "580-256-6508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAULT",
        "first_name": "LANDON",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-04",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4667",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4667",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "4667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201061880A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.