JERRI BRADSHAW (PA-C) – Physician Assistant, NPI 1609893676
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for JERRI BRADSHAW (PA-C)
3776 DOGWOOD RD
ARDMORE, OK 734017953
Phone: (580) 302-4447
Type: Mailing
PO BOX 776084
CHICAGO, IL 606776084
Phone:
Type: Mailing
16370 US HIGHWAY 70
LONE GROVE, OK 734436535
Phone: (580) 224-2862
Fax: (580) 224-2863
Type: Location
Family Health Center Convenient Care Clinic, 1306, 12th Avenue Northwest, Ardmore, Carter County, Oklahoma, 73401, United States
ARDMORE, OK 734011285
Phone: (580) 223-6003
Fax: (580) 223-6999
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 104 Open Payments records for all available years, with a total value of $1,902.
Total Amount is formed as General ($1,902) + Research ($0) + Ownership ($0) = $1,902.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($320).
Total Amount
$1,902
General + Research + Ownership
Payments
104
Total payment records
General Amount
$1,902
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $320 |
| GlaxoSmithKline, LLC. | $268 |
| Insulet Corporation | $234 |
| Novo Nordisk Inc | $229 |
| Lilly USA, LLC | $138 |
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: 2007-11-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051118000437 | I | Physician Assistant | OK | TBD |
| I20071128000186 | I | Physician Assistant | TX | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 507 | 296 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 168 | 168 | $0 |
| G0008 | Administration of influenza virus vaccine | 76 | 74 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 75 | 68 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 71 | 70 | $0 |
Insurance plans in this area (ZIP 73401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Pediatric Medicine | OK | |
| - | OK | |
| Physician Assistant | OK | |
| - | OK | |
| Internal Medicine | OK | |
| U R O L O G Y | OK | |
| - | OK | |
| U R O L O G Y | OK | |
| - | OK | |
| Family Practice | OK |
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