NPIMap

Individual provider Active NPI

Jerry T McLaughlin, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1952373326
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
750 Issued in OK
Practice address
3110 SW 89TH St
Suite 200E
Oklahoma City, OK 73159-7920
Phone
(405) 733-7300
Fax
(405) 733-7333
NPI assigned
Feb 1, 2006
Last updated
Aug 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 750 OK Primary

Addresses

Primary practice location

3110 SW 89TH St
Suite 200E
Oklahoma City, OK 73159-7920

Mailing address

3110 SW 89TH St Ste 200E
Oklahoma City, OK 73159-7919
Phone (405) 733-7300

Other identifiers 1

IdentifierTypeStateIssuer
100126440AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040521000802 OK Practitioner - Physician Assistant 2860483468 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zann McMahan MD PCGroup PAC ID 9436218948, 2 clinicians

Practice addresses (Care Compare)

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

7006 Broadway Ext
Oklahoma City, OK 73116-9006
Phone (405) 916-4545

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
750OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coal County General Hospital CurrentSince Apr 15, 2014 Accepting new patients
Coal County General Hospital CurrentSince Apr 15, 2014 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Terrell R Phillips DO Inc PastSince Jun 7, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients
McBride Clinic Orthopedic Hospital, LLC Physician Assistant Past Accepting new patients
Img Clinic PLLC PastSince Mar 6, 2022 Accepting new patients

Locations

6 N Covington St
Coalgate, OK 74538
Phone (580) 927-2327

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1952373326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST STE 200E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597919",
            "telephone_number": "405-733-7300",
            "fax_number": "405-733-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST",
            "address_2": "SUITE 200E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597920",
            "telephone_number": "405-733-7300",
            "fax_number": "405-733-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "JERRY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100126440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.