Jack Wade Lethermon, DNP PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

214986 Issued in OK

Practice address

505 W 1St St
Claremore, OK 74017-7803

Phone

(918) 606-5225

NPI assigned

Aug 29, 2023

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 TX, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

85.12 of 100Reported as group

Quality

83.76

Promoting interoperability

100

Improvement activities

40

Cost

56.64

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlethermon21905@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 and National Provider Directory roles.

• Creek Nation Hospital & Clinics

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

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Lighthouse Behavioral Wellness Centers

  • Community/Behavioral Health Agency
  • Ardmore, OK
  • NPI 1518997097
  Medicare reassignment
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Jenks, OK
  • NPI 1699375998
  NPD
• Creek Nation Hospital & Clinics

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

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1316722119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 S DIVISION ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740665706",
            "telephone_number": "918-606-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W 1ST ST",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740177803",
            "telephone_number": "918-606-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETHERMON",
        "first_name": "JACK",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DNP PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "214986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Patrick Lee, PHARM.D.
• Phana Lee
• Sophia Lefrere, LCSW
• Angela Grace Leigh, CNIM
• Chelsea Breann Leonard, OD
• Mattie Lethermon, AGACNP-BC
• Amber Michelle Leuellen
• Miranda Leeann Lewis, OT
• Pamela Lewis, CSFA
• Teresa Jean Lewis, B.S.

• Psychiatric/Mental Health Nurse Practitioner in Claremore, OK
• Providers in Claremore, OK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.