Active NPI
Jerry Earl Joern, PA
- Physician Assistant
- Lexington, OK
National Provider Identifier
1215207113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 243
- Practice address
- 15151 E. Hwy 39
Lexington, OK 73051 - Phone
- (405) 527-5676
- NPI assigned
- Jan 9, 2012
- Last updated
- Nov 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 243 | OK | Primary |
Addresses
Primary practice location
15151 E. Hwy 39
Lexington, OK 73051
Mailing address
14613 Fossil Creek LN
Oklahoma City, OK 73134-1838
Phone (405) 752-0672
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 243 | OK | MD | Occupational Therapy Assistant |
Interoperability endpoints
- jjoern183182@direct.integrisok.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509926400000",
"number": "1215207113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14613 FOSSIL CREEK LN",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731341838",
"telephone_number": "405-752-0672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15151 E. HWY 39",
"city": "LEXINGTON",
"state": "OK",
"postal_code": "73051",
"telephone_number": "405-527-5676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOERN",
"first_name": "JERRY",
"middle_name": "EARL",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-09",
"last_updated": "2017-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.