Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1487774618 Deactivated / Inactive NPI Male Practitioner

Jon Mark Lauderdale , PA-C

Physician Assistant • Owasso, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jon Lauderdale has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 30, 2007
NPI Deactivation Date February 08, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Jon Lauderdale, PA-C was a registered Physician Assistant practicing in Owasso, OK. Throughout an active medical career spanning 16 years, Jon Lauderdale provided care at the practice location at 13616 E 103RD ST N until profile deactivation on 2023-02-08.

Practice Location & Contact Primary Location

Practice Address

13616 E 103rd St N
Ste A

Owasso, OK 740554586

Telephone 9182748555
Fax 9182748556
Associated Practice Facility / Clinic
🏢 Advanced Imaging Resources Co Facility NPI 1902850993

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Owasso, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.6 Yrs
State Avg: 14.2 Yrs
Regional Practice Density
16 Specialists

Practicing in Owasso, OK (1911 Statewide)

Telehealth Adoption Rate
31.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA-3470

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Bryan Marsh , MD

Family Medicine

NPI 1033258959

Doctor of Medicine (M.D.)

Prarthana Bhat

Nurse Practitioner - Family

NPI 1194568733
Heath Welton , PA-C

Physician Assistant

NPI 1225262892

Physician Assistant (Certified)

Dr. Wesley Ingram , DO

Family Medicine

NPI 1346200714

Doctor of Osteopathic Medicine (D.O.)

Dr. Steven Treat , DO

Emergency Medicine

NPI 1427091388

Doctor of Osteopathic Medicine (D.O.)

Zachary Robertson , PA

Physician Assistant - Medical

NPI 1588625701

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 08, 2023

Record deactivated on February 08, 2023

NPI Profile Active April 15, 2009

NPI status registered as active in NPPES database

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Updated Practice Location April 15, 2009

Registered at 13616 E 103RD ST N, STE A, OWASSO, OK 740554586 (Tel: 9182748555)

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Updated Business Mailing Address April 15, 2009

Registered at 13616 E 103RD ST N, STE A, OWASSO, OK 740554586 (Tel: 9182748555)

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Provider Name / Credentials Updated April 15, 2009

Recorded as JON LAUDERDALE, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2009

Physician Assistant (License #PA-3470 in FL)

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Initial NPI Registration & Enumeration March 30, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487774618
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 30, 2007
Last Update: April 15, 2009
Deactivation Date: February 08, 2023

Mailing Address

13616 E 103rd St N, Ste A

Owasso, OK 740554586

Phone: 9182748555

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.