NPIMap

Individual provider Active NPI

Jedidiah J Perdue, MD, MPH

  • Psychiatry Physician
  • Edmond, OK
National Provider Identifier
1750578332
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
26278 Issued in OK
Practice address
4509 Integris Pkwy Ste 300
Edmond, OK 73034-8696
Phone
(405) 657-3704
Fax
(405) 657-3892
NPI assigned
Sep 27, 2007
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 26278 OK Primary

Addresses

Primary practice location

4509 Integris Pkwy Ste 300
Edmond, OK 73034-8696

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 657-3704

Other identifiers 1

IdentifierTypeStateIssuer
200521480AMedicaidOK

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
I20140220000221 OK Practitioner - Psychiatry 8224268131 Reassigns benefits to 2 organizations
I20250224001117 TX Practitioner - Psychiatry 8224268131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Oklahoma College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980

2301 W I 44 Service Rd
Suite 200
Oklahoma City, OK 73112-8766
Phone (405) 759-0413

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26278OKMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health Current Accepting new patients
Pinnacle Psychiatry LLC Psychiatry CurrentSince Jan 16, 2025 Accepting new patients
Integris Ambulatory Care Corporation CurrentSince Oct 30, 2020 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Feb 13, 2025 Accepting new patients
Chickasaw Nation Division of Health CurrentSince Feb 13, 2025 Accepting new patients
Chickasaw Nation Division of Health Past Accepting new patients

Locations

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

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

4509 Integris Pkwy
Ste 200
Edmond, OK 73034
Phone (405) 657-3895

4509 Integris Pkwy
Ste 300
Edmond, OK 73034
Phone (405) 657-3704

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

2301 W I 44 Service Rd
Ste 200
Oklahoma City, OK 73112
Phone (405) 286-1016

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

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: jperdue210090@direct.integrisok.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1750578332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-657-3704",
            "fax_number": "405-657-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 INTEGRIS PKWY STE 300",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348696",
            "telephone_number": "405-657-3704",
            "fax_number": "405-657-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "JEDIDIAH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "26278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200521480A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.