RANDI LYN TODD (NPI# 1588265383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588265383 |
| Entity Type | Individual |
| Full Name | RANDI LYN TODD |
| Credential | PARA PROFESSIONAL |
| Practice Address |
618 E Canadian Ave Vinita OK 74301-3810 |
| Mailing Address |
Po Box 148 Vinita OK 74301-0148 |
| Practice Telephone | 9182449877 |
| Mailing Telephone | 9182449877 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Street Address |
618 E CANADIAN AVE |
| City | VINITA |
| State | OK |
| Zip Code | 74301-3810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114351541 | Santa Fe Residential Care Home | Clinic/Center | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2013-08-21 |
| 1083215867 | Robert Frank Tipton Jr. | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2020-11-06 |
| 1023345279 | Vickie Jean Tipton | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2009-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740786 | Jennifer Lynn Black | Registered Nurse | 24919 S 4420 Road, Vinita, OK 74301 | 2020-11-03 |
| 1720686272 | Chancie Marie Cooper | Case Manager/Care Coordinator | 444 737 Hwy 28, Vinita, OK 74301 | 2020-10-15 |
| 1265082515 | Ruth Irving | Technician | 843 North Miller, Vinita, OK 74301 | 2019-09-18 |
| 1952897449 | Sarah Renee Gilmore | Behavior Technician | 526 N. Brewer, Vinita, OK 74301 | 2018-07-08 |
| 1134664683 | Sheila Mason | Nurse Practitioner | Department of Veterans Affairs Clinic, 269 South 7th Street, Vinita, OK 74301 | 2016-12-19 |
| 1881145274 | Saint Francis Hospital Vinita, Inc | Clinic/Center | 711 North Brewer Street, Vinita, OK 74301 | 2016-10-20 |
| 1699147249 | Beth Powell | Peer Specialist | 405 East Excelsior Ave, Vinita, OK 74301 | 2015-10-22 |
| 1790196202 | Peter Rausch | Psychologist | 735 N. Foreman St., Vinita, OK 74301 | 2014-05-19 |
| 1548605041 | Anita Joy Cantrell | Counselor | 1520 North Industrial Ave, Vinita, OK 74301 | 2013-05-10 |
| 1033469606 | Matt Lance Oldacre | Pharmacist | 525 S. Wilson, Vinita, OK 74301 | 2012-09-11 |
| Find all providers in zip 74301 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316142722 | Orchard Grove Rcf | Assisted Living Facility | 35010 S 4465 Rd, Vinita, OK 74301-6672 | 2007-06-16 |
| 1407051816 | Rambling Rose Dba Orchard Grove Rcf | Assisted Living Facility | 35164 S 4465 Rd, Vinita, OK 74301-6782 | 2007-06-16 |
| 1083215867 | Robert Frank Tipton Jr. | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2020-11-06 |
| 1346685542 | Miller's Residential Care, LLC | Assisted Living Facility | 203 N Gunter St, Vinita, OK 74301-2903 | 2013-05-02 |
| 1023345279 | Vickie Jean Tipton | Assisted Living Facility | 618 E Canadian Ave, Vinita, OK 74301-3810 | 2009-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124359047 | 3c Old Fashion Boarding Home | Assisted Living Facility | 719 S Jim Thorpe Blvd, Nbu 1706, Prague, OK 74864-3505 | 2010-01-15 |
| 1558690792 | Burdine Inc | Assisted Living Facility | 214 S. Fourth St., Red Bird, OK 74458-0096 | 2009-12-17 |
| 1801918784 | Fair Oaks Residential Care LLC | Assisted Living Facility | 1330 N 3rd St, Langley, OK 74350 | 2007-04-04 |
| 1134250731 | Helen Farris | Assisted Living Facility | 17963 S 543 Road, Tahlequah, OK 74464 | 2007-03-08 |
| 1538299417 | Sugar Mountain Retreat, Inc. | Assisted Living Facility | 26403 S 581 Rd, Welling, OK 74471-2303 | 2007-03-07 |
| 1700114253 | High Cedar Residential Care | Assisted Living Facility | 18601 Cedar Ln, Noble, OK 73068-5915 | 2009-11-20 |
| 1992835888 | Lake Francis Residential Care Home, LLC | Assisted Living Facility | 27753 S Welling Rd, Welling, OK 74471-2202 | 2007-03-07 |
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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.