NPIMap

Individual provider Active NPI

Jeremy S Cheatwood, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1477825164
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2110 Issued in OK
Practice address
13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone
(405) 418-4500
Fax
(405) 418-4501
NPI assigned
Jan 27, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2110 OK Primary

Addresses

Primary practice location

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431

Mailing address

13100 N Western Ave Ste 200
Oklahoma City, OK 73114-1431
Phone (405) 418-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000036 OK Practitioner - Physician Assistant 6800056433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newman Memorial Hospital, IncGroup PAC ID 2567482367, 29 clinicians
Oklahoma City Orthopedics and Sports Medicine PLLCGroup PAC ID 0345209326, 3 clinicians
Urgent Med LLCGroup PAC ID 5193747707, 7 clinicians

Practice addresses (Care Compare)

1000 15TH St
Woodward, OK 73801-3008
Phone (580) 571-3160

1015 SW 4TH St
Moore, OK 73160-2404
Phone (405) 418-4500

1650 Main St
Woodward, OK 73801-3046
Phone (405) 418-4500

2004 N Hwy 81
Duncan, OK 73533-1449
Phone (580) 252-1911

2222 W Iowa Ave
Chickasha, OK 73018-2738
Phone (405) 418-4500

905 S Main
Shattuck, OK 73858-9205

905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2110OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Newman Memorial Hospital, Inc CurrentSince Jul 10, 2023 Accepting new patients
Newman Memorial Hospital, Inc. Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Grady Memorial Hospital Past Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients
Newman Memorial Hospital, Inc Past Accepting new patients
Newman Memorial Hospital, Inc. Past Accepting new patients

Locations

905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551

1000 15th St
Woodward, OK 73801
Phone (580) 256-2820

Interoperability endpoints

  • Direct secure messaging: jcheatwood452044@direct-ehr-ssmhc.com
  • Direct secure messaging: jeremy.cheatwood.1@14517.direct.athenahealth.com
  • Direct secure messaging: jeremy.cheatwoodpac.p1@direct.okc.nextgenshare.com

Organizations & group practices 10

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477825164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 N WESTERN AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731141431",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATWOOD",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.