Clayton David Dejarnett, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1945 Issued in OK

Practice address

10512 North 110TH East Avenue
Owasso, OK 74055-6638

Phone

(918) 376-8900

Fax

(918) 272-7475

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

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.

• Ahs Henryetta Hospital LLC

  • Rural Health Clinic/Center
  • Henryetta, OK
  • NPI 1871008722
  NPD (past)
• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1891723896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVENUE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044013",
            "telephone_number": "918-579-3826",
            "fax_number": "918-579-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10512 NORTH 110TH EAST AVENUE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740556638",
            "telephone_number": "918-376-8900",
            "fax_number": "918-272-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJARNETT",
        "first_name": "CLAYTON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "1945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100123160B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalee Davis
• Chloe Lynn Riley Dawson
• Joseph W Day, DMD
• Timothy Dearhamer
• Diana L Defelice, DO
• Deborah Jean Dejarnett, DO
• Victoria Delaney, APRN
• Denise Johnson, OD,PLLC
• April Breanne Denney, PHARM.D
• Dental Depot of Owasso, PLLC

• Family Medicine Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.