Jerry K Myers, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E2757 Issued in TX

Practice address

5500 Kell Blvd
Suite 100
Wichita Falls, TX 76310-1612

Phone

(940) 696-5335

Fax

(940) 696-1114

NPI assigned

Jul 7, 2005

Reactivated

Mar 28, 2006

Last updated

Dec 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
• Direct secure messaging: jmyers14368@unitedregional.medalliesdirect.net

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.

• Kell West Regional Hospital LLC

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1669480323
  NPD (past) Authorized official
• Texoma Primary Care Clinic

  • Family Nurse Practitioner
  • Wichita Falls, TX
  • NPI 1497123772
  Authorized official Same address or phone
• United Regional Health Care System Inc

  dba United Regional Heath Care System

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448
  NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1851399505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KELL BLVD",
            "address_2": "SUITE 100",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763101612",
            "telephone_number": "940-696-5335",
            "fax_number": "940-696-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KELL BLVD",
            "address_2": "SUITE 100",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763101612",
            "telephone_number": "940-696-5335",
            "fax_number": "940-696-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JERRY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-12-19",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "E2757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110622103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81720X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "081928184",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eid B Mustafa, MD
• Abigail Muths
• Elizabeth Mulewa Mutinda, LP
• Alan Scott Myers, MD
• Amanda Renee Myers
• Julia Lee Myers
• Myrna C de Asis MD PA
• Stephanie Angel Nader, RBT
• Shehzadi Ghazala Nagra, MD
• Larissa Naim, FNP-C

• Surgery Physician in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.