MS. MARCIA JEAN RICKETSON (NPI# 1720010416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720010416 |
| Entity Type | Individual |
| Full Name | MS. MARCIA JEAN RICKETSON |
| Credential | P.A.C. |
| Practice Address |
216 Ne 12th St Moore OK 73160-5830 |
| Mailing Address |
2829 Chaucer Dr Oklahoma City OK 73120-2804 |
| Practice Telephone | 4057942530 |
| Practice Fax Number | 8663716223 |
| Mailing Telephone | 4054968059 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2009-06-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 710 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
216 NE 12TH ST |
| City | MOORE |
| State | OK |
| Zip Code | 73160-5830 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669968954 | United Surgical Associates, Pllc | Physician Assistant | 2119 Riverwalk Dr # 115, Moore, OK 73160-2700 | 2018-07-10 |
| 1023553187 | Jessica Elise Jackson | Physician Assistant | 2109 S Santa Fe Ave, Moore, OK 73160-2807 | 2016-12-28 |
| 1114188232 | Cassandra Gentry | Physician Assistant | 1105 Sw 30th Ct, Moore, OK 73160-2887 | 2008-06-20 |
| 1265597553 | Neneth Oakley Phung | Physician Assistant | 2733 South I-35 Service Road, Moore, OK 73160 | 2006-12-27 |
| 1831258516 | Thompson Healthcare Provider Services LLC | Physician Assistant | 16444 Interstate Highway 35 South, Moore, TX 78057 | 2006-12-08 |
| 1942218755 | Rebecca R Wellington | Physician Assistant | 2900 S Telephone Rd, Ste. 250, Moore, OK 73160-2968 | 2006-08-04 |
| 1730115577 | Iftikhar A Sandhu | Physician Assistant | 2212 N Broadway St, Moore, OK 73160-4303 | 2006-06-23 |
| 1104440619 | Kaitlin Elizabeth Shaw | Physician Assistant | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2020-05-31 |
| 1295241339 | Mitchell Williams | Physician Assistant | 2109 S Santa Fe Ave, Moore, OK 73160-2807 | 2017-12-27 |
| 1497281455 | Jennifer Kay Dunning | Physician Assistant | 1105 Sw 30th Ct, Moore, OK 73160-2887 | 2017-05-11 |
| Find all providers in MOORE | ||||
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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.