MR. JACOB ANDERSON (NPI# 1104351709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104351709 |
| Entity Type | Individual |
| Full Name | MR. JACOB ANDERSON |
| Practice Address |
142 W Main St Durant OK 74701-5008 |
| Practice Telephone | 5809202069 |
| Practice Fax Number | 5809201010 |
| Mailing Telephone | 5809202069 |
| Mailing Fax Number | 5809201010 |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346802253 | Jacob Anderson | Behavior Technician | 1905 Daniels St Apt 10, Vancouver, WA 98660-2500 | 2019-07-01 |
| 1942619374 | Jacob Ray Anderson | Physical Therapist | 1110 Civic Center Blvd Ste. 502, Yuba City, CA 95993 | 2014-08-11 |
| 1356621163 | Jacob Stewart Anderson | Occupational Therapist | 1899 Tate Blvd Se Ste 2106, Hickory, NC 28602 | 2011-08-24 |
| 1902020761 | Jacob Christian Anderson | Occupational Therapist | 301 Nobles Ln, Old Orchard Beach, ME 04064-1627 | 2007-04-12 |
| 1659830669 | Jacob Anderson | Radiology | 600 Highland Ave, Madison, WI 53792-3440 | 2019-03-19 |
| 1891264990 | Jacob M Anderson | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-11-19 |
| 1538658158 | Jacob Boone Anderson | Student in an Organized Health Care Education/Training Program | 1514 Jefferson Hwy, New Orleans, LA 70121-2483 | 2018-05-09 |
| 1023507035 | Jacob Anderson | Family Medicine | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2018-05-04 |
| 1710494687 | Jacob Kyle Anderson | Nurse Anesthetist, Certified Registered | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2018-01-02 |
| 1467801266 | Jacob Anderson | Internal Medicine | 245 N 15th St, 6th Floor, Philadelphia, PA 19102-1101 | 2016-06-13 |
| Street Address |
142 W MAIN ST |
| City | DURANT |
| State | OK |
| Zip Code | 74701-5008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891273512 | Emalea Del Hudgens | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2018-08-03 |
| 1487023784 | Emma Hicks | Social Worker | 142 W Main St, Durant, OK 74701-5008 | 2015-09-17 |
| 1760875348 | Hunter Rambo | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2015-03-06 |
| 1811240872 | Gary Todd Cole | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2012-10-16 |
| 1417211251 | Deborah Dailey | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2012-06-26 |
| 1053673269 | Lucas Freeman | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2012-06-13 |
| 1336414044 | Natasha Comeaux | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2012-03-13 |
| 1740551340 | Sean Hodgkins | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2012-01-13 |
| 1326323288 | Chealsie R Wines | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2011-10-11 |
| 1124323985 | Charity Eidson | Counselor | 142 W Main St, Durant, OK 74701-5008 | 2011-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803626 | Jason Don Shoemaker | Case Manager/Care Coordinator | 5202 Pheasant Run, Durant, OK 74701-2443 | 2020-05-26 |
| 1457907602 | Tera M Lester | Case Manager/Care Coordinator | 1313 N 16th Ave, Durant, OK 74701-2134 | 2019-08-14 |
| 1891350260 | Maryann Almaguer | Case Manager/Care Coordinator | 1105 W Elm St, Durant, OK 74701-4135 | 2019-05-01 |
| 1346719606 | Tayler Denise Marcy | Case Manager/Care Coordinator | 2008 Four Seasons Dr, Durant, OK 74701-2434 | 2018-11-15 |
| 1639658867 | Dillon Cook | Case Manager/Care Coordinator | 5174 Silo Rd, Durant, OK 74701-7577 | 2018-08-08 |
| 1538653365 | James Christie Jr. | Case Manager/Care Coordinator | 4323 Osage St, Durant, OK 74701-1612 | 2018-06-15 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1427505510 | Ryan Shane Cook | Case Manager/Care Coordinator | 1101 Baltimore St, Durant, OK 74701-3241 | 2016-09-06 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in DURANT | ||||
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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.