CORTNEY JACKSON


Address: Sioc 1624 Cimarron Plaza, Stillwater, OK 74075-3467
Phone: 4053387072

CORTNEY JACKSON (NPI# 1477197267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477197267
Entity Type Individual
Full Name CORTNEY JACKSON
Practice Address Sioc 1624 Cimarron Plaza
Stillwater
OK 74075-3467
Practice Telephone 4053387072
Mailing Telephone 4053387072
Enumeration Date 2019-11-05
Last Update Date 2019-12-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist K082948200 OK Other Service Providers

Office Location

Street Address SIOC 1624 CIMARRON PLAZA
City STILLWATER
State OK
Zip Code 74075-3467

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205495421 Caitlyn A Lewis Peer Specialist 1624 Cimaron Plaza, Stillwater, OK 74075 2019-06-11
1861915316 Chelsea Keel Counselor 3800 N Washington St, Stillwater, OK 74075 2017-07-17
1740475375 Paula Dawn Evans Marriage & Family Therapist 110 E Lakeview Drive, Stillwater, OK 74075 2007-09-06
1194942102 Trey Ratzlaff Physical Therapy Assistant 1810 N Perkins Road, Stillwater, OK 74075 2007-04-19
1629197678 Melissa Sue Cox Dietitian, Registered 4700 West Mcelroy, Stillwater, OK 74075 2007-03-29
1033210851 Robert Anton Crotty Podiatrist 120 N Perkins Rd, Ste A, Stillwater, OK 74075 2006-09-26
1235242074 Ross Hospice of Ponca City, LLC Hospice Care, Community Based 1020 N Boomer Rd Ste 1, Stillwater, OK 74075 2006-08-16
1033156559 Hac Inc Pharmacy 421 N. Main, Stillwater, OK 74075 2006-06-01
1912404583 Hunter Elizabeth Schlosser Case Manager/Care Coordinator 421 E Thomas Ave, Stillwater, OK 74075 2018-04-10
1295246213 Melissa Kay Wilson-watts Case Manager/Care Coordinator 421 E Thomas Ave, Stillwater, OK 74075 2017-10-17
Find all providers in zip 74075

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407455892 Kristen Michelle Stock Peer Specialist 804 N Dryden Cir, Stillwater, OK 74075-7108 2020-10-18
1457962722 Keyata I Wright Peer Specialist 2502 N Glenwood Dr, Stillwater, OK 74075-2624 2020-08-11
1639702277 Tresor Mason Peer Specialist 3003 E 4th Ave Unit 22, Stillwater, OK 74074-8366 2020-02-21
1437794542 Paige Dannette Morse Peer Specialist 1009 E Brooke Ave, Stillwater, OK 74075-2907 2019-11-12
1063060630 John Thomas Jardot Peer Specialist 4100 W 19th Ave Apt H104, Stillwater, OK 74074-1610 2019-08-27
1366095861 Kelsey Lyn Bigheart Peer Specialist 5421 S Deer Trail, Stillwater, OK 74074 2019-07-23
1811559354 Sean Matthew Boehm Peer Specialist 3214 E Peachtree Ave, Stillwater, OK 74074-6407 2019-07-04
1205495421 Caitlyn A Lewis Peer Specialist 1624 Cimaron Plaza, Stillwater, OK 74075 2019-06-11
1942808464 Kayla Dawn Crews Peer Specialist 1624 Cimarron Plz, Stillwater, OK 74075-3467 2020-10-16
1881291946 Tommy Len Waite Peer Specialist 1624 Cimarron Plz, Stillwater, OK 74075-3467 2020-10-01
Find all providers in STILLWATER

Competitor

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City STILLWATER
Zip Code 74075

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Dataset Information

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.

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