Jerry Ladon Outlaw, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-070149 Issued in AL

Practice address

145 Katherine Ave.
Ozark, AL 36360-1987

Phone

(334) 774-5116

Fax

(334) 774-6848

NPI assigned

Aug 29, 2012

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 FL

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Florida Healthcare, Inc.Group PAC ID 2668363771, 37 clinicians

Southland Hospitlalist at Chipley PLGroup PAC ID 9537382494, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Florida Community Hospital Hospital, Chipley, FL, CCN 101308

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/liberty-4ff80e3e

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.

• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Medicare reassignment Care Compare group NPD
• Southland Hospitlalist at Chipley, PL.

  • Hospitalist Physician
  • Chipley, FL
  • NPI 1801213020
  Medicare reassignment Care Compare group NPD
• Calhoun-Liberty Hospital Association Inc

  • Skilled Nursing Facility
  • Blountstown, FL
  • NPI 1033434196
  Medicare reassignment NPD
• Calhoun-Liberty Hospital Association Inc

  • Emergency Care Clinic/Center
  • Blountstown, FL
  • NPI 1649596784
  Medicare reassignment NPD
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Enterprise, AL
  • NPI 1952845711
  NPD
• Southland Hospitalist at Ozark, PL

  • Emergency Medicine Physician
  • Ozark, AL
  • NPI 1750608949
  NPD
• Southland Medical Solutions of Ozark, PL

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ozark, AL
  • NPI 1144545500
  NPD
• Northwest Florida Healthcare, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Chipley, FL
  • NPI 1659438760
  NPD
• Calhoun Liberty Hospital Association, Inc.

  • Critical Access Hospital
  • Blountstown, FL
  • NPI 1437253085
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Care Compare affiliation

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1609125202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KATHERINE AVE.",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363601987",
            "telephone_number": "334-774-5116",
            "fax_number": "334-774-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KATHERINE AVE.",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363601987",
            "telephone_number": "334-774-5116",
            "fax_number": "334-774-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "JERRY",
        "middle_name": "LADON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-070149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Nixon, LPC
• Jacey Makayla Norman, RBT
• Oak River Counseling, LLC
• Oasis Counseling Services, LLC
• Olawumi Ikeade Ogedengbe
• Oz Psychology, LLC
• Ozark Chiropractic and Wellness Center LLC
• Ozark City
• Ozark Counseling Center (Occ)
• Ozark Family Dental PC

• Family Nurse Practitioner in Ozark, AL
• Providers in Ozark, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.