Ronald Jefferson, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G29488 Issued in CA

Practice address

4211 Avalon Blvd
Los Angeles, CA 90011-5622

Phone

(323) 432-5185

NPI assigned

Jul 18, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ronald.jefferson@kcc.eclinicaldirectplus.com

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.

• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1780877613
  NPD (past)
• Pediatric and Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1316044522
  NPD (past)
• St Francis Medical Center

  • Long Term Care Hospital
  • Lynwood, CA
  • NPI 1346378270
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1730389800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 OCEAN TERRACE DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755756",
            "telephone_number": "310-668-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-432-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G29488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madisyn Jefferson
• Melissa Elizabeth Jefferson
• Mondray Arnel Jefferson
• Myrna Jefferson
• Nancy Adrianne Jefferson, LCSW
• Sonny Makeala Jefferson, MD
• Maria Jeffery, LCSW
• Christina Marie Jeffords, APCC
• Jeffrey a. Berman MD Inc
• Jeffrey Brumbaugh, DDS, Ms, Inc.

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.