NPIMap

Organization Active NPI

Jeffrey K McIlroy MD Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
National Provider Identifier
1053531830
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JEFFREY K MCILROY MD INC
Practice address
2990 N Sioux Ave
Claremore, OK 74017-3700
Phone
(918) 342-2622
Fax
(918) 342-2641
NPI assigned
Apr 26, 2007
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Terry Featherston
Title
Office Manager
Phone
(918) 342-2622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

2990 N Sioux Ave
Claremore, OK 74017-3700

Mailing address

2990 N Sioux Ave
Claremore, OK 74017-3700
Phone (918) 342-2622

Other identifiers 1

IdentifierTypeStateIssuer
200054200AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000657 OK Part B Supplier - Clinic/Group Practice 8527962216 Receives reassigned benefits from 25 practitioners
Practice locations: Broken Arrow, OK; Claremore, OK

National Provider Directory

National Provider Directory

Locations

8937 S Garnett Rd
Broken Arrow, OK 74012
Phone (918) 342-2622

2990 N Sioux Ave
Claremore, OK 74017
Phone (918) 342-2622

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1053531830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 N SIOUX AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173700",
            "telephone_number": "918-342-2622",
            "fax_number": "918-342-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 N SIOUX AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173700",
            "telephone_number": "918-342-2622",
            "fax_number": "918-342-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY K MCILROY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "FEATHERSTON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-342-2622"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200054200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.