MR. MATTHEW TACKETT (NPI# 1124650593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124650593 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW TACKETT |
| Practice Address |
121 S Duck St Stillwater OK 74074-3292 |
| Mailing Address |
2017 Karr Ct Stillwater OK 74075-8235 |
| Practice Telephone | 6179062617 |
| Mailing Telephone | 6179062617 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588721757 | Matthew Brian Tackett | Chiropractor | 6800 Us Highway 23 S, Suite 3, Pikeville, KY 41501-3701 | 2007-01-03 |
| Street Address |
121 S DUCK ST |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-3292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881061885 | Tayler Hall | Counselor | 121 S Duck St, Ste. 1, Stillwater, OK 74074-3292 | 2015-08-25 |
| 1104469840 | Monique Canaday | Behavioral Analyst | 121 S Duck St, Stillwater, OK 74074-3292 | 2019-10-25 |
| 1740751379 | Lisa Lee Bell | Counselor | 121 S Duck St, Stillwater, OK 74074-3292 | 2018-12-07 |
| 1790204048 | Samantha Finlay | Counselor | 121 S Duck St, Stillwater, OK 74074-3292 | 2017-09-18 |
| 1013446293 | Kaylie Marie Anderson | Counselor | 121 S Duck St, Stillwater, OK 74074-3292 | 2017-06-09 |
| 1235667114 | Jaiden Samantha Butler | Behavior Technician | 121 S Duck St, Stillwater, OK 74074-3292 | 2017-05-23 |
| 1255883898 | Amber Whitson | Behavior Technician | 121 S Duck St, Stillwater, OK 74074-3292 | 2016-10-31 |
| 1548628423 | Jeremiah Edward Grissett | Marriage & Family Therapist | 121 S Duck St, Stillwater, OK 74074-3292 | 2016-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| 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 |
|---|---|---|---|---|
| 1306444823 | Kristal Rose Spitler | Case Manager/Care Coordinator | 3524 S Husband St, Stillwater, OK 74074-7538 | 2020-10-16 |
| 1649877002 | Ania Leanne Davis | Case Manager/Care Coordinator | 1505 W 15th Ave Unit 1, Stillwater, OK 74074-5252 | 2020-10-07 |
| 1891302865 | Ann Lorraine Brzozowske | Case Manager/Care Coordinator | 11109 W 56th Ave, Stillwater, OK 74074-2147 | 2020-09-24 |
| 1467066514 | Tonya Rene Tyner | Case Manager/Care Coordinator | 1406 S Duncan St, Stillwater, OK 74074-5820 | 2020-09-05 |
| 1104436864 | Savanah R Brown | Case Manager/Care Coordinator | 824 N. Washington St, Stillwater, OK 74075-7407 | 2020-08-06 |
| 1285251546 | Chelsea Keig | Case Manager/Care Coordinator | 815 E Will Rogers Dr, Stillwater, OK 74075-5736 | 2020-07-02 |
| 1386269942 | Kenoria Izhane Fletcher | Case Manager/Care Coordinator | 2711 N Copper Mountain Dr, Stillwater, OK 74075-4809 | 2020-06-10 |
| 1063034106 | Hailey Hardesty | Case Manager/Care Coordinator | 110 S Berry St, Stillwater, OK 74074-3835 | 2020-05-12 |
| 1528603032 | Joel Russell Wingo | Case Manager/Care Coordinator | Grand Lake Mental Health Center Inc., 604 S. Walnut St., Stillwater, OK 74074-4222 | 2019-11-08 |
| 1992263537 | Clayton Scott Camp | Case Manager/Care Coordinator | 5512 W 7th Ave, Stillwater, OK 74074-1124 | 2019-03-02 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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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.