Ethan Jernigan, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

7284 Issued in OK

Practice address

3401 W Gore Blvd
Lawton, OK 73505-6332

Phone

(580) 355-8620

NPI assigned

Apr 23, 2020

Last updated

Aug 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Lester E. Cox Medical Centers

  dba Shell Knob Family Medicine

  • Family Medicine Physician
  • Shell Knob, MO
  • NPI 1538334396
  Medicare reassignment NPD
• Mercy Hospital Aurora

  • Critical Access Hospital
  • Aurora, MO
  • NPI 1467543090
  Medicare reassignment NPD
• Mercy Hospital Cassville

  • Critical Access Hospital
  • Cassville, MO
  • NPI 1285676932
  Medicare reassignment NPD
• Mercy Hospital Springfield

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1043242159
  Medicare reassignment NPD
• Mercy St. Francis Hospital

  • Critical Access Hospital
  • Mountain View, MO
  • NPI 1023053477
  Medicare reassignment NPD
• Lester E Cox Medical Centers

  dba CoxHealth Neurology

  • Neurology Physician
  • Springfield, MO
  • NPI 1023763414
  NPD
• Lester E Cox Medical Centers

  dba Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1922126077

  Emergency Medicine

  NPD
• Mercy Hospital Aurora

  • Medicare Defined Swing Bed Hospital Unit
  • Aurora, MO
  • NPI 1295878981
  NPD
• Mercy Hospital Cassville

  • Medicare Defined Swing Bed Hospital Unit
  • Cassville, MO
  • NPI 1154535342
  NPD
• Mercy Hospital Springfield

  • Medicare Defined Swing Bed Hospital Unit
  • Springfield, MO
  • NPI 1053907113
  NPD
• Mercy St. Francis Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Mountain View, MO
  • NPI 1043357015
  NPD

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1790305456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658021917",
            "country_code": "US",
            "telephone_number": "417-269-9812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075210",
            "country_code": "US",
            "telephone_number": "417-269-9812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022048662",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanetia Jenkins, MS
• Jennifer Baker, LMFT-S LLC
• Jennifer Baker, LMFT, LLC
• Lisa G Jensen, LPC
• Ricardo Alberto Jerez, LPC
• Cole Jesperson, DDS
• Jim Taliaferro CMHC
• Jim Taliaferro Community Mental Health
• Jim Taliaferro Community Mental Health Center
• Jim Taliaferro Community Mental Health Center

• Emergency Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.