Jeffery Allen Barentine, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1567 Issued in OK

Practice address

28622 E 141St St S
Coweta, OK 74429-7515

Phone

(918) 486-7425

Fax

(918) 279-6884

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coweta Medical Group,P.L.L.C.

  • Primary Care Clinic/Center
  • Coweta, OK
  • NPI 1316183536

  OK

  Medicare reassignment
• David D Moon DO PC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1326232067
  NPD (past)
• East Tulsa Medical Group

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1114336534
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1104997436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28622 E 141ST ST S",
            "address_2": "PO BOX 1030",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744297515",
            "telephone_number": "918-486-7425",
            "fax_number": "918-279-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28622 E 141ST ST S",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744297515",
            "telephone_number": "918-486-7425",
            "fax_number": "918-279-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARENTINE",
        "first_name": "JEFFERY",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1072574",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE LICENSE",
            "identifier": "1567",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Todd Anderson, DO
• Kyle A Anderson, DC
• Arkansas Verdigris Valley Health Centers, Inc.
• Kylee Nicole Armstrong, SLP
• Boerje A. Axelsson, M.D.
• Shelly Barlow
• Alyssa Barron, PHARMD.
• Natalie Jeane Bartell, FNP
• Alyssa Bear
• Jerry L Beggs

• All providers in Coweta, OK
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.