Individual provider Active NPI

Andrew Jimerson, NP-C, PMGT-BC

  • Family Nurse Practitioner
  • Norman, OK
National Provider Identifier
1376079780
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
104858 Issued in OK
Practice address
3110 N Interstate Dr Ste 120
Norman, OK 73072-7206
Phone
(405) 759-8407
Fax
(405) 724-6482
NPI assigned
May 4, 2017
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104858 OK Primary

Addresses

Primary practice location

3110 N Interstate Dr Ste 120
Norman, OK 73072-7206

Mailing address

3110 N Interstate Dr Ste 120
Norman, OK 73072-7206
Phone (405) 759-8407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200114002945 OK Practitioner - Nurse Practitioner 9739514027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avenstar Pain Specialists PLLCGroup PAC ID 1153632344, 3 clinicians
JWS Medical PLLCGroup PAC ID 5991196933, 4 clinicians

Practice addresses (Care Compare)

1732 S Sooner Rd
Midwest City, OK 73110-2668
Phone (405) 438-0913

3411 W Rock Creek Rd
Suite 120
Norman, OK 73072-2466
Phone (405) 759-8407

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.24 of 100Reported as individual
Quality
56.71
Improvement activities
40
Cost
70.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
104858OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avenstar Pain Specialists, PLLC CurrentSince Dec 26, 2019 Accepting new patients
JWS Medical, PLLC Past Accepting new patients

Locations

1732 S Sooner Rd
Oklahoma City, OK 73110
Phone (405) 408-9274

5104 S Sooner Rd
Oklahoma City, OK 73135
Phone (405) 438-0913

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGEHCD

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1376079780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 N INTERSTATE DR STE 120",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730727206",
            "telephone_number": "405-759-8407",
            "fax_number": "405-724-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 N INTERSTATE DR STE 120",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730727206",
            "telephone_number": "405-759-8407",
            "fax_number": "405-724-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMERSON",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "NP-C, PMGT-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "104858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.