Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daxton Thane Grigsby, PA

Individual provider Physician Assistant · NPI 1407584717

Daxton Thane Grigsby, PA is a Physician Assistant in Tahlequah, Oklahoma. Qualified in 2024, 2 years ago. Practices with Cherokee Nation, a 448-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
2
Licensed in
OK
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

19600 E Ross St
Tahlequah, OK 74464-0545
Phone: (539) 234-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5469 (OK)

Record details

NPI number1407584717
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 13, 2022
Last updated in NPPESJuly 15, 2025
Certification dateJuly 15, 2025
Mailing address4502 E 41st St, Tulsa, OK 74135-2536

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Cherokee Nation — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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