Individual provider Active NPI

Jalal Ghafil, MS, RD,LD

  • Registered Dietitian
  • Edmond, OK
National Provider Identifier
1497304190
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2265 Issued in OK
Practice address
1 S Broadway Ste 303
Edmond, OK 73034-3706
Phone
(405) 696-6917
NPI assigned
Sep 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2265 OK Primary

Addresses

Primary practice location

1 S Broadway Ste 303
Edmond, OK 73034-3706

Mailing address

20 E Blanch Ave
Edmond, OK 73034-3633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191220001245 OK Practitioner - Registered Dietitian Or Nutrition Professional 0941634117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2265OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Oct 24, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Oct 24, 2024 Accepting new patients

Locations

1200 Childrens Ave
Ste 4D
Oklahoma City, OK 73104
Phone (405) 271-6764

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1497304190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E BLANCH AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S BROADWAY STE 303",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343706",
            "telephone_number": "405-696-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAFIL",
        "first_name": "JALAL",
        "credential": "MS, RD,LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "2265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.