Peter Werner Eckhardt, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000127 Issued in OK

Practice address

900 E Airport Road
Okmulgee, OK 74447

Phone

(918) 756-9211

Fax

(918) 756-9452

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: peckhardt17991@muscogeecreeknation.direct-ci.com

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.

• State of Oklahoma

  • Skilled Nursing Facility
  • Okmulgee, OK
  • NPI 1881872182
  NPD (past)
• State of Oklahoma

  • Long Term Care Hospital
  • Okmulgee, OK
  • NPI 1912158098
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962557744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1118",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744471118",
            "telephone_number": "918-756-9211",
            "fax_number": "918-756-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E AIRPORT ROAD",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "74447",
            "telephone_number": "918-756-9211",
            "fax_number": "918-756-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHARDT",
        "first_name": "PETER",
        "middle_name": "WERNER",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "000127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.