Jeremy Bouwhuis, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6921 Issued in OK

Practice address

4301 Wilson St
Fort Sill, OK 73503-4472

Phone

(833) 286-3732

NPI assigned

Feb 11, 2016

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1508225186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "833-286-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "833-286-3732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-2462",
            "fax_number": "253-968-2972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUWHUIS",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexy Lynn Blake, DMD
• Phillip Blake, PHARMD
• Margaret Theresa Bleckler, OTR
• Jared T Bosh, DMD
• Jumok K Bottoms, PA
• Lori Bridges, PHARM.D
• Brian Bromley, D.O.
• Angelyn Marie Brown, DNP
• Austin Carroll Brown, PA
• Cassie Lynn Brown, O.D.

• Internal Medicine Physician in Fort Sill, OK
• Providers in Fort Sill, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.