Jesse Michael Farmer Sr., RN

Key facts

NPI

1003781808

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Registered Nurse 163WG0000X

License

2014022224 (MO)

Practice address

1252 N 4080 Rd
Boswell, OK 74727-9265

Phone

(660) 654-4009

NPI assigned

Oct 9, 2025

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 9, 2025.

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1003781808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 N 4080 RD",
            "city": "BOSWELL",
            "state": "OK",
            "postal_code": "747279265",
            "telephone_number": "660-654-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 N 4080 RD",
            "city": "BOSWELL",
            "state": "OK",
            "postal_code": "747279265",
            "telephone_number": "660-654-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "name_suffix": "Sr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MO",
            "license": "2014022224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boswell, OK

• Amelia Gayle Lee
• Boswell Public Schools
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• Ashley Smallwood

All providers in Boswell, OK · General Practice Registered Nurse in Oklahoma