Individual provider Active NPI

Jessica B. Gebhart, RD, LD

  • Registered Dietitian
  • Oklahoma City, OK
National Provider Identifier
1154156446
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2931 Issued in OK
Practice address
4200 W Memorial Rd Ste 802
Oklahoma City, OK 73120-8305
Phone
(952) 428-9271
NPI assigned
Sep 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2931 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd Ste 802
Oklahoma City, OK 73120-8305

Mailing address

1220 Mockingbird LN
Edmond, OK 73034-5788
Phone (952) 428-9271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708001233 OK Practitioner - Registered Dietitian Or Nutrition Professional 2163936642 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2931OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Jul 1, 2025 Accepting new patients

Locations

4140 W Memorial Rd
Ste 215
Oklahoma City, OK 73120
Phone (405) 242-4030

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Organizations & group practices 1

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": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1154156446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MOCKINGBIRD LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345788",
            "telephone_number": "952-428-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD STE 802",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208305",
            "telephone_number": "952-428-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHART",
        "first_name": "JESSICA",
        "middle_name": "B.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.