JERRY LADON OUTLAW (CRNP) – Family Nurse Practitioner, NPI 1609125202

JERRY LADON OUTLAW (CRNP) is a healthcare provider. based in Ozark, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-070149 (AL). The NPI Number for JERRY LADON OUTLAW (CRNP) is 1609125202

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
JERRY LADON OUTLAW (CRNP)
NPI
1609125202
Phone
(334) 774-5116
Address
145 KATHERINE AVE.
Enumeration Date
29 August 2012
Last Update Date
29 August 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8506381610
Graduation Year
2012 (14 years ago)
PAC ID
3072745546
Group Practice PAC ID
9537382494
Professional Enrollment ID
I20171116001942
Address ID
FL324286303CH1360XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for JERRY LADON OUTLAW (CRNP)

  • 145 KATHERINE AVE.

    OZARK, AL 363601987

    Phone: (334) 774-5116

    Fax: (334) 774-6848

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $33.

Total Amount is formed as General ($33) + Research ($0) + Ownership ($0) = $33.

Last reported payment date: 2023-10-10 • Largest payer in this snapshot: ABBVIE INC. ($18).

Total Amount

$33

General + Research + Ownership

Payments

2

Total payment records

General Amount

$33

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$18
Lilly USA, LLC$15
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-11-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140415002272INurse PractitionerALTBD
I20171116001942INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36360)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537382494View full group profile
NameSpecialtyState
Emergency Medicine, General PracticeFL

Reviews

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Frequently asked questions

Is JERRY LADON OUTLAW (CRNP) listed with a National Provider Identifier?
Yes — JERRY LADON OUTLAW (CRNP) has NPI 1609125202 on file in the registry.
Active or inactive — what applies to JERRY LADON OUTLAW (CRNP)?
You should see JERRY LADON OUTLAW (CRNP) as active in CMS-hosted NPPES data.
What clinical focus is listed for JERRY LADON OUTLAW (CRNP)?
At a glance, JERRY LADON OUTLAW (CRNP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JERRY LADON OUTLAW (CRNP)?
Travel planning: use Ozark, Alabama as the reference point for JERRY LADON OUTLAW (CRNP), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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