Herndon Gideon, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

82547 Issued in OK

Practice address

12 E Macarthur St
Shawnee, OK 74804-2135

Phone

(405) 275-1001

NPI assigned

May 6, 2015

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 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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Williams Medical Group Practice, LLCGroup PAC ID 3375832157, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Williams Medical Group Practice, LLC

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809
  Medicare reassignment Care Compare group NPD
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Shawnee, OK
  • NPI 1184294910
  NPD (past)
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Tulsa, OK
  • NPI 1750950580
  NPD (past)

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1508243858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 GRACELANN",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042372",
            "telephone_number": "580-380-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042135",
            "telephone_number": "405-275-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDEON",
        "first_name": "HERNDON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "82547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christa L Gerber, PHARMD
• Jennifer L Geren, LCSW
• Jonathan Gibbs
• Dillon Gibson, MAT, LAT, ATC
• Regetta Ann Gibson, PHARMD
• Magdelon Gilbert, RD, LD
• Sierra Gilbert
• Aaron Charles Mark Gilley, LAT, ATC
• Curtis G. Gilley, LBP
• Heather Gilmore

• Family Nurse Practitioner in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.