CHARLIE RENEE GORDON (NPI# 1699111815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699111815 |
| Entity Type | Individual |
| Full Name | CHARLIE RENEE GORDON |
| Credential | BHRS |
| Practice Address |
112 N High St Antlers OK 74523-2250 |
| Mailing Address |
814 N Highland St Seminole OK 74868-3270 |
| Practice Telephone | 5802983001 |
| Mailing Telephone | 4053032735 |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457561045 | Charlie J Gordon IIi | Driver | 1000 N 92nd St, Milwaukee, WI 53226-3533 | 2007-05-23 |
| Street Address |
112 N HIGH ST |
| City | ANTLERS |
| State | OK |
| Zip Code | 74523-2250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942558796 | Jane Marva Breckenridge | Psychologist | 112 N High St, Antlers, OK 74523-2250 | 2012-08-28 |
| 1689085011 | David Delker | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2014-05-20 |
| 1629488119 | Kathy Brokar | Counselor | 112 N High St, Antlers, OK 74523-2250 | 2014-05-06 |
| 1043646060 | George E Williamson | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-09-23 |
| 1083055933 | Kathy L Pendergraft | Counselor | 112 N High St, Antlers, OK 74523-2250 | 2013-07-08 |
| 1245671106 | Candace R Chaney | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-07-08 |
| 1164863015 | Kathy Gardenhire | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-07-08 |
| 1386084143 | Natalie Rochelle Cook | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-06-26 |
| 1225478134 | Jennifer C Jacks | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-06-25 |
| 1740620640 | Chantelle G Cowan | Behavioral Analyst | 112 N High St, Antlers, OK 74523-2250 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942793351 | Terry Jean Draper | Nurse Practitioner | 416020 E 1951 Rd, Antlers, OK 74523 | 2018-06-11 |
| 1134628456 | Breiana Jacobs | Case Manager/Care Coordinator | 107 South High St, Antlers, OK 74523 | 2018-02-02 |
| 1174072482 | Crossroads 1010 LLC | Community/Behavioral Health | 193908 Us Hwy 271, Antlers, OK 74523 | 2016-09-27 |
| 1700277092 | Katherine Jill Maple | Registered Nurse | 506 Hwy 271 North, Antlers, OK 74523 | 2015-02-09 |
| 1366884975 | Jessica L. Rowan | Speech-Language Pathologist | 426297 State Highway 3, Antlers, OK 74523 | 2013-07-24 |
| 1235432444 | Charis Kay Griffin | Psychologist | 903 West Main St., Antlers, OK 74523 | 2010-12-09 |
| 1629213889 | Hometown Quality Care, Inc | Home Health | 191475 N 4140 Rd Ste 3, Antlers, OK 74523 | 2008-12-02 |
| 1841491214 | Zen Gee Counseling & Psychological Serv LLC | Community/Behavioral Health | 608 Highway 271 North, Antlers, OK 74523 | 2007-05-31 |
| 1376689422 | Marcia Leigh Armstrong | Counselor | 608 Hwy 271 North, Antlers, OK 74523 | 2007-01-29 |
| 1831247691 | Chance J Lawless | Dentist | 412 N Hwy 271, Antlers, OK 74523 | 2007-01-08 |
| Find all providers in zip 74523 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841815727 | Ashley Dawn Self | Case Manager/Care Coordinator | 191638 N 4110, Antlers, OK 74523-7452 | 2020-06-16 |
| 1134628456 | Breiana Jacobs | Case Manager/Care Coordinator | 107 South High St, Antlers, OK 74523 | 2018-02-02 |
| 1316210578 | Patti Lynn Allensworth | Case Manager/Care Coordinator | Rr 2 Box 2230, Antlers, OK 74523-9716 | 2012-02-20 |
| 1649507872 | Monica Lavette Nabors | Case Manager/Care Coordinator | Rr 2 Box 785, Antlers, OK 74523-9708 | 2009-11-09 |
| 1376783639 | Lee Harris | Case Manager/Care Coordinator | Hc 83 Box 2260, Antlers, OK 74523-9463 | 2009-02-26 |
| 1619160579 | Brian Mattingly | Case Manager/Care Coordinator | Hc 83 Box 905, Antlers, OK 74523-9428 | 2007-08-23 |
| 1073151148 | Tracy Ann Bailey | Case Manager/Care Coordinator | 301 N High St, Antlers, OK 74523-2238 | 2019-12-19 |
| 1932672078 | Melissa Dawn Clem | Case Manager/Care Coordinator | 301 N High St, Antlers, OK 74523-2238 | 2019-01-10 |
| 1134627524 | Jasmine Amoni Dirks | Case Manager/Care Coordinator | 107 S High St, Antlers, OK 74523-3818 | 2018-01-31 |
| 1154839892 | Amanda Renee Mckitrick | Case Manager/Care Coordinator | 107 S High St, Antlers, OK 74523-3818 | 2018-01-16 |
| Find all providers in ANTLERS | ||||
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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.