Individual provider Active NPI

John W Click, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1972616159
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA162 Issued in OK
Practice address
4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone
(405) 948-4900
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 PA162 OK Primary

Addresses

Primary practice location

4913 W Reno Ave
Oklahoma City, OK 73127-6339

Mailing address

3134 NW 60TH St
Oklahoma City, OK 73112-4205
Phone (405) 842-6188

Other identifiers 1

IdentifierTypeStateIssuer
1600162MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
162OKMDOral and Maxillofacial Surgery (Dentist)
PA162OKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972616159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 NW 60TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124205",
            "telephone_number": "405-842-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLICK",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1600162",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.