Active NPI
Cedar Jackson, ARNP
- Women's Health Nurse Practitioner
- Tinker Afb, OK
National Provider Identifier
1336354125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- R 0055120
- Practice address
- 7050 Air Depot Blvd
Tinker Afb, OK 73145 - Phone
- (405) 582-6146
- NPI assigned
- May 14, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | R 0055120 | OK | Primary |
Addresses
Primary practice location
7050 Air Depot Blvd
Tinker Afb, OK 73145
Mailing address
4031 Michael Rd
Edmond, OK 73025
Phone (405) 359-5690
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
| License | State | Type | Specialty |
|---|---|---|---|
| R 0055120 | OK | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1336354125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4031 MICHAEL RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "73025",
"telephone_number": "405-359-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 AIR DEPOT BLVD",
"city": "TINKER AFB",
"state": "OK",
"postal_code": "73145",
"telephone_number": "405-582-6146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CEDAR",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OK",
"license": "R 0055120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinker Afb, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.