Individual provider Active NPI

Jeremy Bearden, DO

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1154380780
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4053 Issued in OK
Practice address
4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone
(918) 728-6145
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4053 OK Primary

Addresses

Primary practice location

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229

Mailing address

4500 S Garnett Rd
Ste 919
Tulsa, OK 74146-5229
Phone (918) 728-6145

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
I20031208000991 OK Practitioner - Emergency Medicine 1052217494 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4053OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Emergency Services PC Emergency Medicine CurrentSince Mar 18, 2012 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Oct 9, 2011 Accepting new patients
Emergency Physicians of Mid-America, P.C. Emergency Medicine CurrentSince Dec 1, 2014 Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Lightstar Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Seminole Health Center LLC Past Accepting new patients
Iacc/Ehi NW, LLC Past Accepting new patients
Morningstar Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Integris Canadian Valley Hospital Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (800) 617-7717

4801 SE 15th St
Del City, OK 73115
Phone (405) 500-3380

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

3391 S I 35 Service Rd
Moore, OK 73160
Phone (405) 500-3330

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000

5200 E I 240 Service Rd
Oklahoma City, OK 73135
Phone (405) 608-6000

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

300 S Rockwell Ave
Oklahoma City, OK 73128
Phone (405) 500-3430

3300 NW Expressway St
Oklahoma City, OK 73112
Phone (405) 251-2815

2401 W Wrangler Blvd
Seminole, OK 74868
Phone (405) 303-4000

1102 W MacArthur St
Shawnee, OK 74804
Phone (405) 273-2270

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Organizations & group practices 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1154380780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S GARNETT RD",
            "address_2": "STE 919",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741465229",
            "telephone_number": "918-728-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "JEREMY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.