DR. SEMIRA CHARBONEAU (NPI# 1619975745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619975745 |
| Entity Type | Individual |
| Full Name | DR. SEMIRA CHARBONEAU |
| Credential | D.O. |
| Practice Address |
527 W 3rd St Konawa OK 74849-1415 |
| Practice Telephone | 5809253286 |
| Practice Fax Number | 5809259149 |
| Mailing Telephone | 5809253286 |
| Mailing Fax Number | 5809259149 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2018-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4038 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200011300A | 05 | |
| OK | RAILDROAD MEDICARE | P00035275 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1007 N Country Club Rd, Ada, OK 748202847 | 5804218700 | 5804218785 |
| Street Address |
527 W 3RD ST |
| City | KONAWA |
| State | OK |
| Zip Code | 74849-1415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962407999 | Judy Pearce | Nurse Practitioner | 527 W 3rd St, Konawa, OK 74849-1415 | 2005-06-16 |
| 1366049280 | Kelsey Katherine Hartman | Physician Assistant | 527 W 3rd St, Konawa, OK 74849-1415 | 2020-10-04 |
| 1548886831 | Kelli Lowry | Speech-Language Pathologist | 527 W 3rd St, Konawa, OK 74849-1415 | 2020-06-22 |
| 1407414295 | Roberto Bonilla Gallegos | Case Manager/Care Coordinator | 527 W 3rd St, Konawa, OK 74849-1415 | 2019-06-05 |
| 1750882775 | Amanda Lynn Cubit | Nurse Practitioner | 527 W 3rd St, Konawa, OK 74849-1415 | 2018-02-25 |
| 1376061127 | Cari Renee Gravel | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2017-08-31 |
| 1235659418 | Marilyn Kay Dixon | Case Manager/Care Coordinator | 527 W 3rd St, Konawa, OK 74849-1415 | 2017-06-20 |
| 1881067502 | Paige Vandegrift | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2015-11-03 |
| 1285013540 | Central Oklahoma Family Medical Center, Inc | Specialist | 527 W 3rd St, Konawa, OK 74849-1415 | 2015-05-20 |
| 1255767372 | Lindsey Clark | Social Worker | 527 W 3rd St, Konawa, OK 74849-1415 | 2013-09-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548680176 | Dave Garrett Herriman | Social Worker | 527 W Third Street, Konawa, OK 74849 | 2014-04-22 |
| 1518152529 | Tami Ranae Hernandez | Counselor | 527 West Third St, Konawa, OK 74849 | 2007-09-12 |
| 1427067859 | Erron Cody Proctor | Physician Assistant | 527 West 3rd St, Konawa, OK 74849 | 2006-08-05 |
| 1972519544 | Umar Saeed | Family Medicine | 527 West Third Street, Konawa, OK 74849 | 2006-08-01 |
| 1831291293 | Central Oklahoma Family Medical Center, Inc. | Clinic/Center | 527 West 3rd St, Konawa, OK 74849 | 2006-09-05 |
| 1972725828 | Larna Louise Tribbey | Counselor | 527 West Third Street, Konawa, OK 74849-0000 | 2007-05-02 |
| 1104315829 | Konawa Public Schools | Local Education Agency (LEA) | 701 W South St, Konawa, OK 74849-1417 | 2018-05-08 |
| 1932482957 | Doris Chance | Case Manager/Care Coordinator | 308 W 4th St, Konawa, OK 74849-1612 | 2011-09-26 |
| 1922137314 | Cbw Inc | Intermediate Care Facility, Mental Illness | 308 W 4th St, Konawa, OK 74849-1612 | 2007-03-03 |
| 1255538237 | Gayla Carter | Counselor | 316 N East St, Konawa, OK 74849-1802 | 2007-07-02 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083222038 | Miloni Mukesh Parmar | Internal Medicine | 800 Stanton L Young Blvd Aat 6300, Oklahoma City, OK 73104-5018 | 2020-07-16 |
| 1073133880 | Dr Brandon Bailey Do Pllc | Internal Medicine | 3621 S Elder Blvd, Broken Arrow, OK 74011-1755 | 2020-04-22 |
| 1295366540 | Rebecca Wright Do Pllc | Internal Medicine | 18405 S 4190 Rd, Claremore, OK 74017-5366 | 2020-01-27 |
| 1376181479 | Meraki Wellness Group, LLC | Internal Medicine | 1211 N Shartel Ave Ste 802, Oklahoma City, OK 73103-2425 | 2019-12-19 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1033688270 | Results Medical Aesthetics LLC | Internal Medicine | 8014 S. 101st E. Ave., Suite 200, Tulsa, OK 74133-4580 | 2018-11-16 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1770068827 | Absolute Health Medical Partners LLC | Internal Medicine | 1305 Nw 187th St, Edmond, OK 73012-6206 | 2018-09-25 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1407349442 | Sarah Monther Nimri | Internal Medicine | 1200 Childrens Ave Ste 14046, Oklahoma City, OK 73104-4637 | 2018-06-13 |
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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.