Individual provider Active NPI

George M Jennings, DO

  • Family Medicine Physician
  • Okmulgee, OK
National Provider Identifier
1144392804
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2050 Issued in OK
Practice address
211 N Grand Ave
Okmulgee, OK 74447-4036
Phone
(918) 284-6958
Fax
(918) 759-9989
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2050 OK Primary

Addresses

Primary practice location

211 N Grand Ave
Okmulgee, OK 74447-4036

Mailing address

211 N Grand Ave
Okmulgee, OK 74447-4036
Phone (918) 284-6958

Other identifiers 1

IdentifierTypeStateIssuer
100112190AMedicaidOK

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000689 OK Practitioner - Family Practice 3870768864 Reassigns benefits to 2 organizations
Practice locations: Muskogee, OK; Okmulgee, OK

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creoks Mental Health ServicesGroup PAC ID 0749591469, 39 clinicians

Practice addresses (Care Compare)

4103 S Yale Ave
Suite B
Tulsa, OK 74135-6002
Phone (918) 382-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2050OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creoks Mental Health Services Family Medicine CurrentSince Feb 26, 2022 Accepting new patients
Creek Nation Hospital & Clinics Family Medicine Current Accepting new patients
Creoks Mental Health Services, Inc CurrentSince Feb 26, 2022 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 16, 2014 Accepting new patients
Creoks Mental Health Services Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Mar 16, 2014 Accepting new patients
William R Grubb MD Inc Past Accepting new patients

Locations

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

4103 S Yale Ave
Ste B
Tulsa, OK 74135
Phone (918) 382-7302

Dept 1467
Tulsa, OK 74182

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1144392804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N GRAND AVE",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744474036",
            "telephone_number": "918-284-6958",
            "fax_number": "918-759-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N GRAND AVE",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744474036",
            "telephone_number": "918-284-6958",
            "fax_number": "918-759-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "GEORGE",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okmulgee, OK

Sources for this page

Verify at the official NPI Registry.