Jefferson Michael Jefferson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

900 N Portland Ave # 7
Oklahoma City, OK 73107-6120

Phone

(405) 945-6775

NPI assigned

May 12, 2021

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1770167090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 CHURCHILL WAY",
            "city": "THE VILLAGE",
            "state": "OK",
            "postal_code": "731201151",
            "telephone_number": "405-861-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N PORTLAND AVE # 7",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076120",
            "telephone_number": "405-945-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "JEFFERSON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Alise Jefferson
• Brittany Dianna Nicole Jefferson, CCC-SLP
• Ja'Ron Jefferson, BHRS
• James H Jefferson Jr.
• Jamie Nicole Jefferson, LPN
• Alyssa Paige Jeffery, MD
• Christopher Jeffery, MD
• Jonathan R Jeffery, DDS
• Sybril Renee Jeffery
• Jeffrey F. Hermen

• Peer Specialist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.