Kimberly Rachel Jerdan, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35118 Issued in OK

Practice address

5915 W Memorial Rd Ste 300
Oklahoma City, OK 73142-2022

Phone

(405) 773-6470

Fax

(405) 773-6463

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Enrolled in OK

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

Specialty

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00172

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jerdan Dermatology Laser and Aesthetic Institute PLLC

  • Dermatology Physician
  • Oklahoma City, OK
  • NPI 1033706445
  Medicare reassignment NPD Authorized official
• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1821431891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE STE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125555",
            "telephone_number": "405-773-6470",
            "fax_number": "405-773-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 W MEMORIAL RD STE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422022",
            "telephone_number": "405-773-6470",
            "fax_number": "405-773-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERDAN",
        "first_name": "KIMBERLY",
        "middle_name": "RACHEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "35118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Elizabeth Jensen, PA-C
• Nathan Jensen
• Shelby Lynn Jensen, IBCLC
• Zoe Jeon
• Jerdan Dermatology Laser and Aesthetic Institute PLLC
• Christopher Jerden
• Jeremy M Boucher, MD; PLLC
• Jeri Ellis MD MPH PC
• Lauren Jerichow, APRN-CNP
• Carla Louise Jernigan, RSS, WELLNESS COACH

• Dermatology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Dermatology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.