NPIMap

Individual provider Active NPI

Jerrod Douglas King, D.O.

  • Emergency Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1689108896
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R9793 Issued in TX
Practice address
2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1833
Phone
(361) 902-6762
NPI assigned
Apr 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R9793 TX Primary

Addresses

Primary practice location

2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1833

Mailing address

2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1833
Phone (361) 902-6762

Other practice location 1

1500 E Houston St
Beeville, TX 78102-5312
Phone (361) 354-2000

Other practice location 2

2500 E Main St
Alice, TX 78332-4261
Phone (361) 661-8000

Other practice location 3

1311 General Cavazos Blvd
Kingsville, TX 78363-7150
Phone (361) 595-1661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200603002138 OK Practitioner - Emergency Medicine 9032452305 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians
Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

1 E Clark Bass Blvd
McAlester, OK 74501-4209
Phone (918) 421-6987

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 494-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6870OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ies ER Oklahoma LLC Emergency Medicine CurrentSince Oct 1, 2025 Accepting new patients
Green Country Emergency Physicians Group of Tulsa PLLC Emergency Medicine CurrentSince Oct 16, 2025 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince May 27, 2020 Accepting new patients
Northeastern Health System CurrentSince Nov 1, 2025 Accepting new patients
Northeastern Health System Emergency Medicine Current Accepting new patients
Northeastern Health System CurrentSince Nov 1, 2025 Accepting new patients
McAlester Regional Health Center Authority CurrentSince Oct 1, 2025 Accepting new patients
C3Erow, LLC Past Accepting new patients
Northeastern Health System Emergency Medicine Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1202 N Muskogee Pl
Claremore, OK 74017
Phone (918) 341-2556

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

2401 W Main St
Henryetta, OK 74437
Phone (918) 650-1100

1 E Clark Bass Blvd
McAlester, OK 74501
Phone (918) 421-6941

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: jking1260560@ahs.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 11

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 8

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1689108896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "address_2": "5 WEST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051833",
            "telephone_number": "361-902-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "address_2": "5 WEST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051833",
            "telephone_number": "361-902-6762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Houston St",
            "address_purpose": "LOCATION",
            "city": "Beeville",
            "state": "TX",
            "postal_code": "781025312",
            "country_code": "US",
            "telephone_number": "361-354-2000",
            "fax_number": "361-358-9322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Main St",
            "address_purpose": "LOCATION",
            "city": "Alice",
            "state": "TX",
            "postal_code": "783324261",
            "country_code": "US",
            "telephone_number": "361-661-8000",
            "fax_number": "361-660-5112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1311 General Cavazos Blvd",
            "address_purpose": "LOCATION",
            "city": "Kingsville",
            "state": "TX",
            "postal_code": "783637150",
            "country_code": "US",
            "telephone_number": "361-595-1661",
            "fax_number": "361-595-5005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "JERROD",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R9793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.