KRISTOPHER LEE BUTLER (NPI# 1417445511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417445511 |
| Entity Type | Individual |
| Full Name | KRISTOPHER LEE BUTLER |
| Practice Address |
620 W Grand Ave Ponca City OK 74601-5123 |
| Practice Telephone | 5807621462 |
| Practice Fax Number | 5806577299 |
| Mailing Telephone | 5807621462 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497255889 | Kristopher Butler | Counselor | 3100 Euclid Ave, Cleveland, OH 44115-2508 | 2018-02-13 |
| Street Address |
620 W GRAND AVE |
| City | PONCA CITY |
| State | OK |
| Zip Code | 74601-5123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780717330 | William Cody Shoemaker | Counselor | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2007-03-13 |
| 1386282747 | Donald L Brown | Day Training, Developmentally Disabled Services | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2019-12-17 |
| 1740747278 | Quailla Marrianne Hazen | Case Management | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2019-02-20 |
| 1184176026 | Joni Lantz | Case Manager/Care Coordinator | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2016-10-26 |
| 1205387644 | Shanell Dent | Peer Specialist | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2016-10-20 |
| 1720534688 | Chad Kills Crow | Counselor | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2016-08-31 |
| 1053761338 | Ashley Merz | Counselor | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2016-06-16 |
| 1881056232 | Lindsey Renee Bales | Behavioral Analyst | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2016-03-24 |
| 1790160232 | Paula Elaine Howard | Peer Specialist | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2015-07-27 |
| 1295115590 | Connie Miller | Case Manager/Care Coordinator | 620 W Grand Ave, Ponca City, OK 74601-5123 | 2015-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245867258 | Triad Health Systems LLC | Family Medicine | 2703 N 14th St, Ponca City, OK 74601 | 2020-03-27 |
| 1679096952 | Gabrielle Evangeline Barnes | Case Manager/Care Coordinator | 620 W. Grand, Ponca City, OK 74601 | 2017-07-19 |
| 1942722889 | Kimbra Leigh Anderson | Case Manager/Care Coordinator | 1500 N. 6th, Ponca City, OK 74601 | 2017-07-12 |
| 1033631965 | Kayla Patten | Case Manager/Care Coordinator | 620 W Grand, Ponca, OK 74601 | 2017-07-12 |
| 1639601859 | Affordable Dental | Dentist | 1618 N 5th St Ste 4, Ponca City, OK 74601 | 2017-03-28 |
| 1447627237 | Harold Jason Laughlin Jr. | Chiropractor | 222 E. Grand, Ste. 309, Ponca City, OK 74601 | 2015-08-27 |
| 1578947875 | Jessica James | Social Worker | 1500 N 6th, Ponca City, OK 74601 | 2015-07-16 |
| 1639565153 | Ryian Reyes | Point of Service | 2101 N 14th, Suite 134, Ponca City, OK 74601 | 2015-04-10 |
| 1003253006 | Proving Faithful Investments Inc. | Home Health | 205 W. Hartford Avenue #112, Ponca City, OK 74601 | 2013-05-30 |
| 1427365899 | Quint Allen Whitefield | Dentist | 1618 N. 5th Street, Suite #2, Ponca City, OK 74601 | 2010-09-08 |
| Find all providers in zip 74601 | ||||
| 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 |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1497393243 | Amy Dawn Smith | Peer Specialist | 1713 Clarke St, Ponca City, OK 74601-2912 | 2019-12-11 |
| 1194362913 | Stephanie Lynn Wright | Peer Specialist | 1512 Queens Ave, Ponca City, OK 74604-1321 | 2019-12-01 |
| 1114569738 | Alan Keith Wilcoxson | Peer Specialist | 1801 Blackard Ln, Ponca City, OK 74604-3512 | 2019-10-15 |
| 1437691268 | Kathy Mitchell | Peer Specialist | 332 S Osage St Apt 1, Ponca City, OK 74601-5143 | 2016-11-10 |
| 1114550779 | Edgar Garcia | Peer Specialist | 2225 N Union St, Ponca City, OK 74601-1555 | 2020-02-21 |
| 1558993519 | Brandy Michelle Musgrove | Peer Specialist | 2225 N Union St, Ponca City, OK 74601-1536 | 2020-02-07 |
| 1689214165 | Linda Yvonne Winter | Peer Specialist | 2225 N Union St, Ponca City, OK 74601-1555 | 2020-01-13 |
| 1134774052 | Shaleen Fay Colton | Peer Specialist | 110 N 4th St, Ponca City, OK 74601-4527 | 2019-08-07 |
| Find all providers in PONCA CITY | ||||
| City | PONCA CITY |
| Zip Code | 74601 |
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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.