TOMMIE GAY STANBERRY PA-C
NPI 1194916015
Physician Assistant - Medical in Tishomingo, OK

Q: What is Tommie Stanberry's NPI number?

The NPI number for Tommie Stanberry is 1194916015. It was assigned to this individual provider in the NPPES registry on August 6, 2007.

Q: What is Tommie Stanberry's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Tommie Stanberry was last updated on September 2, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 06, 2007PECOS EnrolledAccepts Medicare Assignment

610 E 24TH ST, TISHOMINGO, OK 73460(580) 371-2343(580) 371-2451 Get Directions Write a Review

NPPES record last updated: September 2, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Tommie Gay Stanberry Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TOMMIE GAY STANBERRY PA-C (NPI 1194916015) is an individual medical provider in Tishomingo, Oklahoma, licensed in Oklahoma (1655) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Ada, and is a graduate of University Of North Dakota School Of Medicine (2007).

NPPES Registry Identity

NPI1194916015

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameTOMMIE GAY STANBERRYCredential: PA-C

Location Address610 E 24TH STTishomingo, OK 73460-3245

Mailing Address610 E 24th StTishomingo, OK 73460-3245 · (580) 371-2343 · Fax (580) 371-2451

Phone(580) 371-2343

Fax(580) 371-2451

Sole ProprietorNo

Medical School CMSUniversity Of North Dakota School Of MedicineGraduated 2007

Enumeration DateAugust 6, 2007

Last NPPES UpdateSeptember 2, 2010

✔ NPI 1194916015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in OK · 1655

610 E 24TH ST, Tishomingo, OK 73460

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Other Identifiers 2

Medicaid200128520AOK

Other1655OK · License Number Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tommie Gay Stanberry Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052486453

PECOS Enrollment IDI20080820000148

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital Ada

Acute Care Hospitals · Ada, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370020

Location430 North Monte VistaAda, OK 74820 · Pontotoc County

Emergency services Birthing friendly

Atoka County Medical Center

Critical Access Hospitals · Atoka, OK

OwnershipGovernment - Hospital District or Authority

CMS Certification Number371300

Location1590 West Liberty RoadAtoka, OK 74525 · Atoka County

Emergency services

Coal County General Hospital, Inc.

Critical Access Hospitals · Coalgate, OK

OwnershipProprietary

CMS Certification Number371319

Location6 North CovingtonCoalgate, OK 74538 · Coal County

Emergency services

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers31 claims31 services$19.20 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers58 claims58 services$108.92 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier20 claims20 services$36.29 avg. paid by Medicare

Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823

DME-Wheelchairs · category DD009N

2 suppliers17 claims17 services$151.19 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers14 claims14 services$26.08 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARCI LYNN BOWEN APRN-CNP

Nurse Practitioner (Family)