Jeffrey Jordan Wilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7326 Issued in OK

Practice address

1313 E 20TH St
Okmulgee, OK 74447-6303

Phone

(918) 591-5721

NPI assigned

Jul 13, 2020

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson17770@muscogeecreeknation.direct-ci.com

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.

• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Community Hospital

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Muscogee (Creek) Nation Physical Rehabilitation Center

  • Rehabilitation Hospital
  • Okmulgee, OK
  • NPI 1891197224
  NPD
• Creek Nation Hospital & Clinics

  dba Muscogee Healing and Recovery Center

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1235757568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 E 107TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741377293",
            "telephone_number": "918-576-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E 20TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476303",
            "telephone_number": "918-591-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JEFFREY",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laresa Williams, APRN
• Sheamekah Sheree Williams
• Heather Willis, PHARM D
• Wilson Family Medical Care
• Andrew Wilson
• Megan Breffney Wilson, D.O.
• Tyler Ray Wilson, OTR/L
• Rebecca Lynn Wollet, COTA/L
• Wonderfully Made Therapy Group, LLC
• Cristi Lynn Woodard

• Dentist in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.