J K at Home

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

J K AT HOME

Practice address

2237 W Memorial Rd Ste 112
Oklahoma City, OK 73134-8064

Phone

(405) 808-3714

NPI assigned

Dec 1, 2022

Organization subpart

No

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

Authorized official

Name

Jillian Herndon

Title

Owner

Phone

(405) 808-3714

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• HAPPY AT HOME Doing business as

Locations

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1811607690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2237 W MEMORIAL RD STE 112",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348064",
            "telephone_number": "405-808-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 W MEMORIAL RD STE 112",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348064",
            "telephone_number": "405-808-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J K AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "HERNDON",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-808-3714"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201149220A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAPPY AT HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Geriatric Medicine (Family Medicine) Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Geriatric Medicine (Family Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.