PROVIDENCE SERVICE CORPORATION OF OKLAHOMA (NPI# 1699817692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699817692 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SERVICE CORPORATION OF OKLAHOMA |
| Practice Address |
4645 W Gore Blvd Ste 5 Lawton OK 73505-5962 |
| Mailing Address |
620 N Craycroft Rd Tucson AZ 85711-1448 |
| Practice Telephone | 5803556800 |
| Practice Fax Number | 5803550666 |
| Mailing Telephone | 5207476694 |
| Mailing Fax Number | 5207476613 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BREEANN HOERNING (AR BILLING MANAGER) |
| Authorized Official Telephone | 5207476694 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740340157 | Providence Service Corporation of Oklahoma | Clinic/Center | 105 Plaza, Madill, OK 73446-2248 | 2006-12-08 |
| 1639239023 | Providence Service Corporation of Oklahoma | Clinic/Center | 301 N High St, Antlers, OK 74523-2238 | 2006-12-08 |
| 1407916802 | Providence Service Corporation of Oklahoma | Clinic/Center | 134 N 12th Ave, Durant, OK 74701-4718 | 2006-12-08 |
| 1033279443 | Providence Service Corporation of Oklahoma | Clinic/Center | 4645 W Gore Blvd Ste 5, Lawton, OK 73505-5962 | 2006-12-08 |
| 1487726170 | Providence Service Corporation of Oklahoma | Clinic/Center | 931 Arlington St Ste 2, Ada, OK 74820-4025 | 2006-11-15 |
| 1295154581 | Providence Service Corporation of Oklahoma | Community/Behavioral Health | 116 Se Ave N, Idabel, OK 74745-5234 | 2014-04-15 |
| 1568504553 | Providence Service Corporation of Oklahoma | Case Management | 134 N 12th Ave, Durant, OK 74701-4718 | 2007-02-13 |
| 1003958091 | Providence Service Corporation of Oklahoma | Case Management | 134 N 12th Ave, Durant, OK 74701-4718 | 2007-02-13 |
| 1811039894 | Providence Service Corporation of Oklahoma | Case Management | 931 Arlington St Ste 2, Ada, OK 74820-4025 | 2007-02-13 |
| 1942342944 | Providence Service Corporation of Oklahoma | Case Management | 105 Plaza, Madill, OK 73446-2248 | 2007-02-13 |
| Street Address |
4645 W GORE BLVD STE 5 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-5962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033279443 | Providence Service Corporation of Oklahoma | Clinic/Center | 4645 W Gore Blvd Ste 5, Lawton, OK 73505-5962 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255791240 | Adrienne Staton | Case Management | 1618 Nw 46th St, Lawton, OK 73505-3202 | 2016-03-03 |
| 1831639343 | Barry Giles | Case Management | 2305 Sw H Ave, Lawton, OK 73505-8103 | 2017-03-02 |
| 1770951642 | Erin Cox | Case Management | 2710 Nw Marion Ave, Lawton, OK 73507-1319 | 2015-09-09 |
| 1154747848 | Arthur Thomas IIi | Case Management | 1817 W Gore Blvd, Lawton, OK 73501-3614 | 2014-03-05 |
| 1710223326 | Jim Taliaferro Community Mental Health Center | Case Management | 602 Sw 38th St, Lawton, OK 73505 | 2012-12-31 |
| 1508100926 | Multi-county Counseling Center | Case Management | 1719 Sw 11th St, Lawton, OK 73501-7305 | 2012-11-26 |
| 1780966739 | Ladonna Harden | Case Management | 1320 Nw Homestead Dr, Suite G, Lawton, OK 73505-5243 | 2011-09-15 |
| 1205127271 | Jim Taliaferro Community Mental Health Center | Case Management | 602 Sw 38th St, Lawton, OK 73505-6912 | 2011-04-26 |
| 1700109360 | Cornerstone Clinical Services | Case Management | 807 Sw F Ave, Lawton, OK 73501-4506 | 2010-03-10 |
| 1467774398 | Cornerstone Clinical Service | Case Management | 807 Sw F Ave, Lawton, OK 73501-4506 | 2010-02-19 |
| Find all providers in LAWTON | ||||
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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.