Individual provider Active NPI

Jordan Herrman

  • Pharmacist
  • Tulsa, OK
National Provider Identifier
1336790054
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18528 Issued in OK
Practice address
6040 S Yale Ave
Tulsa, OK 74135-7412
Phone
(918) 494-4040
NPI assigned
Sep 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18528 OK Primary

Addresses

Primary practice location

6040 S Yale Ave
Tulsa, OK 74135-7412

Mailing address

8106 S Juniper PL
Broken Arrow, OK 74011-6455
Phone (918) 606-7257

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
18528OKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1336790054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106 S JUNIPER PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740116455",
            "telephone_number": "918-606-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357412",
            "telephone_number": "918-494-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMAN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "18528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.