Jerry C Childs Jr., D.O.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

2157 Issued in OK

Practice address

1520 Morning Star
Edmond, OK 73034-6579

Phone

(405) 659-8840

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: jerry.childs.1@17618.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639137409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 MORNING STAR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MORNING STAR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346579",
            "telephone_number": "405-659-8840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Telephone Road",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "OK",
            "postal_code": "73160",
            "country_code": "US",
            "telephone_number": "405-793-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "JERRY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "2157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Lynn Cherry, RN, CNIM
• Danny Tyler Chesser
• Cayly F Chevalier
• Child and Family Therapy LLC
• Latonya Childs Wilson
• Rico Le'Trelle Childs
• Cynthia Chioco, PYS.D
• Brian Lee Choate, ATC
• Kendall Thomas Choate, DPT, ATC, CSCS
• Chosenhearts Wellness LLC

• All providers in Edmond, OK
• Emergency Medical Services (Emergency Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.