Individual provider Active NPI

Jeffery Hayes Kerr, D.M.D.

  • General Practice Dentistry
  • Poteau, OK
National Provider Identifier
1427021328
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5834 Issued in OK
Practice address
5021 N Broadway St
Suite a
Poteau, OK 74953-9433
Phone
(918) 647-9477
Fax
(918) 647-4595
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2830-94 MS
General Practice Dentistry 1223G0001X 5834 OK Primary

Addresses

Primary practice location

5021 N Broadway St
Suite a
Poteau, OK 74953-9433

Mailing address

5021 N Broadway St
Suite a
Poteau, OK 74953-9433
Phone (918) 647-9477

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
2830-94MSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1427021328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 N BROADWAY ST",
            "address_2": "SUITE A",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749539433",
            "telephone_number": "918-647-9477",
            "fax_number": "918-647-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 N BROADWAY ST",
            "address_2": "SUITE A",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749539433",
            "telephone_number": "918-647-9477",
            "fax_number": "918-647-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "JEFFERY",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2830-94",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.