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

Scott Nicholson, PA

Individual provider Physician Assistant · NPI 1033562673

Scott Nicholson, PA is a Physician Assistant in Edmond, Oklahoma. Qualified in 2014, 12 years ago. Practices with Stillwater Medical Center Authority, a 168-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
12
Licensed in
OK
In the registry since
2016
Specialties on file
2
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

1 S Bryant Ave
Edmond, OK 73034-6309
Phone: (405) 341-6100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2676 (OK)
Physician Assistant Taxonomy 363A00000X · Licence 2676 (OK)

Record details

NPI number1033562673
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 19, 2016
Last updated in NPPESMarch 17, 2020
Certification dateMarch 17, 2020
Mailing address7477 E 46th Pl, Tulsa, OK 74145-6305

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Stillwater Medical Center Authority — 168 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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