Organization Active NPI

E R Associates Inc

  • Dermatology Physician
  • Muskogee, OK
National Provider Identifier
1013991835
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
3027 Issued in OK
Legal business name
E R ASSOCIATES INC
Practice address
1524 W Okmulgee St
Muskogee, OK 74401-6741
Phone
(918) 682-5397
Fax
(918) 682-2663
NPI assigned
Dec 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeff D Endsley, DO
Title
Dermatologist
Phone
(918) 682-5397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 3027 OK Primary

Addresses

Primary practice location

1524 W Okmulgee St
Muskogee, OK 74401-6741

Mailing address

1524 W Okmulgee St
Muskogee, OK 74401-6741
Phone (918) 682-5397

Other identifiers 1

IdentifierTypeStateIssuer
445587563001OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070517000065 OK Part B Supplier - Clinic/Group Practice 6103923768 Receives reassigned benefits from 1 practitioner
Practice locations: Muskogee, OK

National Provider Directory

National Provider Directory

Locations

1524 W Okmulgee St
Muskogee, OK 74401
Phone (918) 682-5397

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013991835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744016741",
            "telephone_number": "918-682-5397",
            "fax_number": "918-682-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744016741",
            "telephone_number": "918-682-5397",
            "fax_number": "918-682-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E R ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENDSLEY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "918-682-5397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OK",
            "license": "3027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "445587563001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.