NPIMap

Organization Active NPI

Jenks Health Team, LLC

  • Family Medicine Physician
  • Jenks, OK
National Provider Identifier
1891982625
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JENKS HEALTH TEAM, LLC
Practice address
715 W Main St
Suite S
Jenks, OK 74037-3554
Phone
(918) 299-9447
Fax
(918) 299-5325
NPI assigned
Sep 25, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. Gerald D Wootan, D.O.
Title
Owner
Phone
(918) 299-9447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

715 W Main St
Suite S
Jenks, OK 74037-3554

Mailing address

715 W Main St
Suite S
Jenks, OK 74037-3554
Phone (918) 299-9447

National Provider Directory

National Provider Directory

Locations

715 W Main St
Ste S
Jenks, OK 74037
Phone (918) 299-9447

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1891982625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W MAIN ST",
            "address_2": "SUITE S",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373554",
            "telephone_number": "918-299-9447",
            "fax_number": "918-299-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W MAIN ST",
            "address_2": "SUITE S",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373554",
            "telephone_number": "918-299-9447",
            "fax_number": "918-299-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENKS HEALTH TEAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "WOOTAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-299-9447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenks, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.