NPIMap

Individual provider Active NPI

Jerri Bradshaw, PA-C

  • Physician Assistant
  • Lone Grove, OK
National Provider Identifier
1609893676
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1402 Issued in OK
Practice address
16370 US Highway 70
Lone Grove, OK 73443-6535
Phone
(580) 224-2862
Fax
(580) 224-2863
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 1402 OK Primary

Addresses

Primary practice location

16370 US Highway 70
Lone Grove, OK 73443-6535

Mailing address

PO Box 776084
Chicago, IL 60677-6084

Other identifiers 1

IdentifierTypeStateIssuer
200076780MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051118000437 OK Practitioner - Physician Assistant 5698700755 Reassigns benefits to 2 organizations
I20071128000186 TX Practitioner - Physician Assistant 5698700755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1020 N Commerce St
Mercy Clinic Primary Care Commerce
Ardmore, OK 73401-3920
Phone (580) 223-5311

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

  • Mays Housecall Home Health of Durant Home health agency, Durant, OK, CCN 377748
  • Ideal Home Care, L.P. Home health agency, Ardmore, OK, CCN 377678
  • Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1402OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health CurrentSince Jul 17, 2015 Accepting new patients
Mercy Health Network of the Southern Region Inc Physician Assistant Past Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Health Services-Southern Region, LLC Past Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients

Locations

1007 N Country Club Rd
Ada, OK 74820
Phone (580) 421-8700

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

1001 N Country Club Rd
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1600 N Washington Ave
Durant, OK 74701
Phone (580) 740-0205

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Interoperability endpoints

  • Direct secure messaging: jbradshaw123022@directc.mercy.net

Organizations & group practices 8

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.

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1609893676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16370 US HIGHWAY 70",
            "city": "LONE GROVE",
            "state": "OK",
            "postal_code": "734436535",
            "telephone_number": "580-224-2862",
            "fax_number": "580-224-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JERRI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200076780",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Grove, OK

Sources for this page

Verify at the official NPI Registry.