Individual provider Active NPI

Jon Tevebaugh, D.V.M.

  • Veterinarian
  • Cherokee, OK
National Provider Identifier
1235509340
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
4022 Issued in OK
Practice address
61950 Grant Rd
Cherokee, OK 73728-5503
Phone
(580) 596-3500
Fax
(580) 536-3501
NPI assigned
Oct 1, 2015
Last updated
Oct 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 4022 OK Primary

Addresses

Primary practice location

61950 Grant Rd
Cherokee, OK 73728-5503

Mailing address

61950 Grant Rd
Cherokee, OK 73728-5503
Phone (580) 596-3500

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4022OKMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1235509340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61950 GRANT RD",
            "city": "CHEROKEE",
            "state": "OK",
            "postal_code": "737285503",
            "telephone_number": "580-596-3500",
            "fax_number": "580-596-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61950 GRANT RD",
            "city": "CHEROKEE",
            "state": "OK",
            "postal_code": "737285503",
            "telephone_number": "580-596-3500",
            "fax_number": "580-536-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEVEBAUGH",
        "first_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.V.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "OK",
            "license": "4022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.