Individual provider Active NPI

Jennifer Caldwell

  • Independent Duty Corpsman
  • Tinker Afb, OK
National Provider Identifier
1912974007
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
7641 Mercury Rd
Tinker Afb, OK 73145-8707
Phone
(405) 739-3990
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

7641 Mercury Rd
Tinker Afb, OK 73145-8707

Mailing address

10504 Willow Ridge Dr
Midwest City, OK 73130-6034

Other identifiers 1

IdentifierTypeStateIssuer
1710I1002XOtherOKINDEPENDENT DUTY CORPSMAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1912974007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10504 WILLOW RIDGE DR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7641 MERCURY RD",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458707",
            "telephone_number": "405-739-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT DUTY CORPSMAN",
            "identifier": "1710I1002X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinker Afb, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.