DR. JACK WADE LETHERMON DNP PMHNP
NPI 1316722119
Nurse Practitioner - Psychiatric/Mental Health in Claremore, OK

Active since August 29, 2023PECOS Enrolled
505 W 1ST ST, CLAREMORE, OK 74017(918) 606-5225 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 8, 2024, Aug 29, 2023 (2 updates tracked since 2023).

About Dr. Jack Wade Lethermon Dnp Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK WADE LETHERMON DNP PMHNP (NPI 1316722119) is an individual psychiatric/mental health provider in Claremore, Oklahoma, licensed in Oklahoma (214986) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316722119
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameDR. JACK WADE LETHERMONCredential: DNP PMHNP
Location Address505 W 1ST STClaremore, OK 74017-7803
Mailing Address904 S Division StSapulpa, OK 74066-5706 · (918) 606-5225
Sole ProprietorNo
Enumeration DateAugust 29, 2023
Last NPPES UpdateApril 8, 20242 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
NPI 1316722119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in OK · 214986
505 W 1ST ST, Claremore, OK 74017

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jack Wade Lethermon Dnp Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
505 W 1ST ST
CLAREMORE, OK 74017
Counselor
505 W 1ST ST
CLAREMORE, OK 74017
Counselor (Mental Health)
505 W 1ST ST
CLAREMORE, OK 74017
Counselor (Mental Health)
505 W 1ST ST
CLAREMORE, OK 74017
Counselor (Mental Health)
505 W 1ST ST
CLAREMORE, OK 74017
Counselor (Mental Health)
505 W 1ST ST
CLAREMORE, OK 74017

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Lethermon's NPI number?

The NPI number for Jack Lethermon is 1316722119. It was assigned to this individual provider in the NPPES registry on August 29, 2023.

Where is Jack Lethermon located?

Jack Lethermon practices at 505 W 1st St, Claremore, OK 74017. The listed phone number is (918) 606-5225.

What is Jack Lethermon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jack Lethermon enrolled in Medicare?

Yes. Jack Lethermon is registered in the Medicare PECOS enrollment system.

What insurance does Jack Lethermon accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Jack Lethermon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Lethermon was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.