NPIMap

Individual provider Active NPI

Jeffrey A Rother, MD

  • Internal Medicine Physician
  • Ardmore, OK
National Provider Identifier
1811951999
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17679 Issued in OK
Practice address
1020 N Commerce St
Ardmore, OK 73401-3920
Phone
(580) 224-2900
Fax
(580) 223-2397
NPI assigned
Apr 14, 2006
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17679 OK Primary

Addresses

Primary practice location

1020 N Commerce St
Ardmore, OK 73401-3920

Mailing address

1020 N Commerce St
Ardmore, OK 73401-3920
Phone (580) 224-2900

Other identifiers 3

IdentifierTypeStateIssuer
110222036OtherMEDICARE RAILROAD
OKAAA0292OtherOKMEDICARE PTAN
100101430AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20061026000280 OK Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0749287290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Oklahoma College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

1020 N Commerce St
Mercy Clinic Primary Care Commerce
Ardmore, OK 73401-3920
Phone (580) 223-5311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17679OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
Jeffrey a Rother, MD, PC Internal Medicine Current Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients

Locations

1020 N Commerce St
Ardmore, OK 73401
Phone (580) 223-5311

1221 G St NW
Ardmore, OK 73401
Phone (580) 224-2900

921 14th Ave NW
Ardmore, OK 73401
Phone (580) 223-5311

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • Direct secure messaging: jrother133222@directc.mercy.net

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 9

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1811951999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N COMMERCE ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013920",
            "telephone_number": "580-224-2900",
            "fax_number": "580-223-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N COMMERCE ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013920",
            "telephone_number": "580-224-2900",
            "fax_number": "580-223-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHER",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "17679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110222036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OKAAA0292",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100101430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.