KENNETH DEMASTERS (NPI# 1073696605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073696605 |
| Entity Type | Individual |
| Full Name | KENNETH DEMASTERS |
| Practice Address |
507 Ne 12th St Moore OK 73160-5807 |
| Mailing Address |
6805 N Woodbrook Rd Warr Acres OK 73132-6413 |
| Practice Telephone | 4057034202 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1077 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
507 NE 12TH ST |
| City | MOORE |
| State | OK |
| Zip Code | 73160-5807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194199 | Darren Elenburg Dpm PC | Podiatrist | 507 Ne 12th St, Moore, OK 73160-5807 | 2019-10-03 |
| 1871069724 | Teisha Alynn Gallegly | Family Medicine | 507 Ne 12th St, Moore, OK 73160-5807 | 2018-10-18 |
| 1659774131 | Jessica Deppen | Nurse Practitioner | 507 Ne 12th St, Moore, OK 73160-5807 | 2014-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392868 | James Scott Turner | Physician Assistant | 924 Nw 14th St, Moore, OK 73160-1610 | 2020-09-23 |
| 1073559373 | Randall Allen Carter | Physician Assistant | 1400 Se 4th St Ste H, Moore, OK 73160 | 2006-06-22 |
| 1104896760 | Lisa Danette West | Physician Assistant | 520 S Telephone Rd, Moore, OK 73160-5423 | 2006-01-25 |
| 1447256193 | Harry B. Taylor | Physician Assistant | 320 N Service Rd, Moore, OK 73160-4945 | 2005-06-27 |
| 1184142259 | Ashley Morgan Garrison | Physician Assistant | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2017-09-08 |
| 1871863712 | Kay B Rochester | Physician Assistant | 1400 Se 4th St, Suite H, Moore, OK 73160-7329 | 2012-01-10 |
| 1114153293 | Mandi Brooke Rhodes | Physician Assistant | 1400 Se 4th St, Ste H, Moore, OK 73160-7329 | 2009-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1568920924 | Direct2u Urgent Care Pllc | Physician Assistant | 2417 County Road 1263, Blanchard, OK 73010-3123 | 2019-03-05 |
| 1538625660 | Symachia LLC | Physician Assistant | 115 N. Main St., Cashion, OK 73106 | 2019-02-13 |
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1316420086 | Lauren Anto | Physician Assistant | 2824 Classen Blvd Ste 100, Norman, OK 73071-4059 | 2018-09-10 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1093240749 | Green's Country Clinic, LLC | Physician Assistant | 223 E Blackwell Ave, Blackwell, OK 74631-2909 | 2017-05-01 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.