SHRONDA L WILSON (NPI# 1609494558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609494558 |
| Entity Type | Individual |
| Full Name | SHRONDA L WILSON |
| Practice Address |
1055 S Houston Ave Tulsa OK 74127-9043 |
| Mailing Address |
5011 S 76th East Ave Apt A Tulsa OK 74145-6208 |
| Practice Telephone | 9189213226 |
| Mailing Telephone | 9184084387 |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1055 S HOUSTON AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74127-9043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265525166 | Toni Gatanis | Nurse Practitioner | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2006-10-02 |
| 1407457708 | Jenifer Nicole Stoycoff | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-11-03 |
| 1467052951 | Destiny Green | Social Worker | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-10-26 |
| 1083211973 | Sarah Kimball Pilgrim | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-10-05 |
| 1700403383 | Catherine Beasley | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-06-30 |
| 1164046751 | Anika-michiko Smith-e-incas-allen | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-05-30 |
| 1124650700 | Yoliana Torres Cleveland | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-02-11 |
| 1851921639 | Rachel Gonshor | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2020-01-22 |
| 1295388767 | Lauren Marie Van Deventer | Case Manager/Care Coordinator | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2019-07-23 |
| 1396305645 | Kathryn Lee Pyle | Social Worker | 1055 S Houston Ave, Tulsa, OK 74127-9043 | 2019-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366966699 | Tarell Lynell Earl | Case Manager/Care Coordinator | 602 N. 28th W. Pl., Tulsa, OK 74127 | 2017-07-28 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1740700988 | Lisa Lee Ann Gilliland | Case Manager/Care Coordinator | 2001 W Ute Pl, Tulsa, OK 74127 | 2017-06-20 |
| 1114456498 | Kevin Thomas Jackson | Counselor | 310 S 49th W Ave, Tulsa, OK 74127 | 2017-06-08 |
| 1427406180 | Byron Conrad Dixon Jr. | Case Manager/Care Coordinator | 551 N. 28th W. Ave., Tulsa, OK 74127 | 2016-06-02 |
| 1548621568 | Brandon Worth | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2016-03-18 |
| 1073987467 | Jo Lowe | Social Worker | 420 S. Lawton Ave. Apt 315, Tulsa, OK 74127 | 2015-11-23 |
| 1154718575 | William Hughes | Health Educator | 3101 W Edison, Tulsa, OK 74127 | 2015-04-23 |
| 1801289665 | Kristyn Janelle Zrenda | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2015-03-17 |
| 1831595719 | Mallory Yarbrough | Counselor | 3005 N 24th West Ave, Tulsa, OK 74127 | 2014-11-05 |
| Find all providers in zip 74127 | ||||
| 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 |
|---|---|---|---|---|
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1275131823 | Deena June Patrick | Peer Specialist | 2536 N Boston Ave, Tulsa, OK 74106-3609 | 2020-10-15 |
| 1760098248 | Eddie L Rodriguez | Peer Specialist | 3821 S Rolling Oaks Dr, Tulsa, OK 74107-4872 | 2020-09-20 |
| 1316553100 | Amber Ponder | Peer Specialist | 7802 W 7th St, Tulsa, OK 74127-5524 | 2020-09-17 |
| 1699380089 | Sunny Shirene Cooper | Peer Specialist | 9933 E 61st St, Tulsa, OK 74133-1504 | 2020-09-11 |
| 1669099875 | Denise Lyn Ely | Peer Specialist | 12 E 12th St, Tulsa, OK 74119-2803 | 2020-07-03 |
| 1831715945 | Kyndell Leigh Mcelwee | Peer Specialist | 5043 S 76th East Ave Apt B, Tulsa, OK 74145-6219 | 2020-06-24 |
| 1548886088 | Dana Kai Stevens | Peer Specialist | 2027 E 12th Pl, Tulsa, OK 74104-4201 | 2020-06-21 |
| 1932723251 | Andrew Jacob Sargent | Peer Specialist | 321 S Frankfort Ave, Tulsa, OK 74120-2428 | 2020-06-02 |
| 1114549656 | Jonathan Michael Holbrook | Peer Specialist | 6963 E 15th Pl Apt 239, Tulsa, OK 74112-7410 | 2020-05-06 |
| Find all providers in TULSA | ||||
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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.