NPIMap

Individual provider Active NPI

Jentry McBroom, PA

  • Physician Assistant
  • Idabel, OK
National Provider Identifier
1801778337
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5486 Issued in OK
Practice address
902 E Lincoln Rd
Idabel, OK 74745-7337
Phone
(580) 286-2600
NPI assigned
Jul 24, 2025
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5486 OK Primary

Addresses

Primary practice location

902 E Lincoln Rd
Idabel, OK 74745-7337

Mailing address

902 E Lincoln Rd
Idabel, OK 74745-7337
Phone (580) 286-2600

Other names 1

  • Jentry Brown Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250924000354 TX Practitioner - Physician Assistant 3173028917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

902 Lincoln Rd
Choctaw National Health Care Idabel
Idabel, OK 74745-7817
Phone (539) 316-6391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5486OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Sep 8, 2025 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 8, 2025 Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8440

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Organizations & group practices 3

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 11

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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1801778337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBROOM",
        "first_name": "JENTRY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENTRY",
            "last_name": "BROWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.