TARA LYNN MERRITT (NPI# 1083174353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083174353 |
| Entity Type | Individual |
| Full Name | TARA LYNN MERRITT |
| Practice Address |
1010 E 45th St Shawnee OK 74804-2202 |
| Mailing Address |
Po Box 3848 Shawnee OK 74802-3848 |
| Practice Telephone | 4052731170 |
| Mailing Telephone | 4052731170 |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891895777 | Tara Ann Merritt | Internal Medicine | 1181 Langford Dr, Bldg 200 Suite 101, Watkinsville, GA 30677-7242 | 2006-09-22 |
| Street Address |
1010 E 45TH ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144331802 | Gateway To Prevention and Recovery, Inc. | Clinic/Center | 1010 E 45th St, Shawnee, OK 74804-2202 | 2006-08-31 |
| 1669090080 | Francis Payton Johnsom | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-13 |
| 1730706821 | Harrison Blake Hartzell | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-06 |
| 1992349427 | Dominque Latreace Simmons | Assistant Behavior Analyst | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-10-28 |
| 1215570452 | Rachel Beiermann | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-10-21 |
| 1174179675 | Amber Nichole Randall | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-08-12 |
| 1962962837 | Sydney Reeves | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-25 |
| 1962962233 | Emalee R Staude | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-22 |
| 1144704974 | Brooke Anson | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2018-09-18 |
| 1093209116 | Tai Keawphalouk | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2018-06-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| 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 |
|---|---|---|---|---|
| 1821600164 | Billy Ray Huff Jr. | Peer Specialist | 134 N Philadelphia Ave, Shawnee, OK 74801-7034 | 2020-08-18 |
| 1750905808 | John Howard Davis | Peer Specialist | 540 W Wallace St, Shawnee, OK 74801-5722 | 2020-06-04 |
| 1801345640 | James Franklin Smith Jr. | Peer Specialist | 1919 N Market Ave, Unit B, Shawnee, OK 74804-3644 | 2016-09-21 |
| 1891248605 | Andrea Scraper | Peer Specialist | 1310 Gordon Cooper Dr, Shawnee, OK 74801-8634 | 2016-07-28 |
| 1730706821 | Harrison Blake Hartzell | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-06 |
| 1093292856 | Lindsey Humphrey | Peer Specialist | 110 W 10th St, Shawnee, OK 74801-6804 | 2018-07-24 |
| 1174013767 | Kathleen Jane Madron | Peer Specialist | 101 N Union Ave, Shawnee, OK 74801-7067 | 2018-05-18 |
| 1568974228 | Watie Wells Jr. | Peer Specialist | 318 N Broadway Ave, Shawnee, OK 74801-6920 | 2017-11-02 |
| 1053831123 | Thomas Riggin Fleming | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2017-06-21 |
| 1417493214 | Carissa Menefee | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2017-01-17 |
| Find all providers in SHAWNEE | ||||
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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.