Jeffrey Jon Jepperson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

61083 Issued in KS

Practice address

520 Pope Ave
US Army Dental Activty
Fort Leavenworth, KS 66027-2332

Phone

(913) 684-5516

NPI assigned

Jan 15, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1144619057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 POPE AVE",
            "address_2": "US ARMY DENTAL ACTIVTY",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 POPE AVE",
            "address_2": "US ARMY DENTAL ACTIVTY",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660272332",
            "telephone_number": "913-684-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPERSON",
        "first_name": "JEFFREY",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "9039485-9922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonore Sylvia Hutchison, BSN RN
• Vivian T. Hutson, RD, LD, FACHE
• Ann Marie Ingala
• Christine A. Jacobs, D.O.
• Beverly Jefferson, RN
• Rachel Lee Jeter, LSCSW
• Elesa Ann Johnson, PT
• Lilly Rose Johnson, LPN
• Rebecca Lynn Johnson, LSCSW
• Thomas Sydney Johnston, RD

• Dentist in Fort Leavenworth, KS
• Providers in Fort Leavenworth, KS by specialty
• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.