Jerry C Bouman DO PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2996 Issued in OK

Legal business name

JERRY C BOUMAN DO PC

Practice address

715 W Main St
Suite H
Jenks, OK 74037-3554

Phone

(918) 296-0900

Fax

(918) 296-0985

NPI assigned

May 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Bouman, MDNPI 1376518217

Title

Physician

Phone

(918) 296-0900

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Craig Bouman, DO

  • Surgery Physician
  • Parsons, KS
  • NPI 1376518217
  NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053522193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21568",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741211568",
            "telephone_number": "918-296-0900",
            "fax_number": "918-296-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W MAIN ST",
            "address_2": "SUITE H",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373554",
            "telephone_number": "918-296-0900",
            "fax_number": "918-296-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY C BOUMAN DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "918-296-0900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "2996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenks Dental Co., PLLC
• Jenks Health Team, LLC
• Jenks Living Centers LLC (Grace Living Center - Jenks)
• Jenks Public Schools
• Jennifer R. Cameron, M.D., P.C.
• Hunter Johnson, DC
• Rachael Johnson, LCSW
• Robert Juan Johnson Jr., DC
• Carolyn Micheale Jones
• Jennifer S. Jones

• Surgery Physician in Jenks, OK
• Providers in Jenks, OK by specialty
• Surgery Physician in Oklahoma

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.