JENNIE GAYLE SIDES (NPI# 1073905626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073905626 |
| Entity Type | Individual |
| Full Name | JENNIE GAYLE SIDES |
| Other Name | MRS. JENNIE GAYLE SADLER |
| Practice Address |
8109 Highway 30 Durham OK 73642-4256 |
| Practice Telephone | 5807997746 |
| Mailing Telephone | 5807997746 |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
8109 HIGHWAY 30 |
| City | DURHAM |
| State | OK |
| Zip Code | 73642-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225864 | Tommy Mcneill | Durable Medical Equipment & Medical Supplies | 3602 Laurel Creek Way, Durham, NC 27712-2982 | 2020-11-08 |
| 1285235218 | Joseph Omalemigbo Abgateyiniro | Durable Medical Equipment & Medical Supplies | 1810 Shiva Court, Durham, NC 27703 | 2020-11-05 |
| 1770184657 | Delia Hearon | Social Worker | 100 Village Circle Way Apt 216, Durham, NC 27713-6131 | 2020-11-05 |
| 1659971315 | Danielle Cullen | Counselor | 839 Onslow St, Durham, NC 27705-4244 | 2020-10-30 |
| 1669072534 | T Transit LLC | Non-emergency Medical Transport (VAN) | 1001 S Duke St, Durham, NC 27707-1339 | 2020-10-29 |
| 1245830215 | Whitney Rains Taheri | Nurse Practitioner | 3004 Tower Blvd, Durham, NC 27707-2542 | 2020-10-29 |
| 1275133183 | Nick Van Ngo | Massage Therapist | 6208 Fayetteville Rd Ste 101, Durham, NC 27713-6286 | 2020-10-29 |
| 1407455991 | Buckeye Psychology Pllc | Clinic/Center | 1310 Fenwick Pkwy, Durham, NC 27713-5829 | 2020-10-26 |
| 1750980256 | Victoria Snow | Social Worker | 504 E Pettigrew St Apt 449, Durham, NC 27701-3888 | 2020-10-26 |
| 1518566066 | Amitkumar Prahaladbhai Patel | Pharmacist | 5450 New Hope Commons Dr # 2137, Durham, NC 27707-9716 | 2020-10-25 |
| Find all providers in DURHAM | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619408713 | Vera Jacobs | Peer Specialist | 415 Princess Ann Dr, Durham, NC 27703-2518 | 2017-03-21 |
| 1154823136 | Yusef Lee | Peer Specialist | 1822 E Nc Highway 54, Durham, NC 27713-3210 | 2018-03-06 |
| 1346742327 | Kristie Wimbush | Peer Specialist | 1822 E Nc Highway 54, Durham, NC 27713-3210 | 2018-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.