MICHELLE RENEE SHADE (NPI# 1720560261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720560261 |
| Entity Type | Individual |
| Full Name | MICHELLE RENEE SHADE |
| Practice Address |
1323 W Keetoowah St Tahlequah OK 74464-3462 |
| Practice Telephone | 9187083006 |
| Practice Fax Number | 9187779016 |
| Mailing Telephone | 9187083006 |
| Mailing Fax Number | 9187779016 |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1323 W KEETOOWAH ST |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-3462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295920734 | Loftin Family Practice | Clinic/Center | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2007-09-07 |
| 1326516022 | Rachel Elizabeth Clinton | Case Manager/Care Coordinator | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2018-11-12 |
| 1548759327 | Holly Caddell | Counselor | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2018-05-07 |
| 1952804106 | Kristina Stricker | Case Manager/Care Coordinator | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2018-03-14 |
| 1326558008 | Stephanie Jolene Whipple | Case Manager/Care Coordinator | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2017-10-06 |
| 1407228752 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2015-10-27 |
| 1740623537 | Jennifer A Baker | Marriage & Family Therapist | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2013-04-10 |
| 1629302674 | Brett Hiseley | Counselor | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2009-09-23 |
| 1881835544 | Kevin W. Perry | Counselor | 1323 W Keetoowah St, Tahlequah, OK 74464-3462 | 2009-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| 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 |
|---|---|---|---|---|
| 1831702638 | Lorna Lorraine Gibbs | Case Manager/Care Coordinator | 1105 Michael St, Tahlequah, OK 74464-7307 | 2020-08-31 |
| 1013548486 | Grant David Neugin | Case Manager/Care Coordinator | 22758 S 494 Rd, Tahlequah, OK 74464-1631 | 2020-02-04 |
| 1134764426 | Claressa Armer | Case Manager/Care Coordinator | 623 W Shawnee St, Tahlequah, OK 74464-3633 | 2019-11-11 |
| 1013574615 | Amber Dawn Anderson | Case Manager/Care Coordinator | 420 N Oklahoma Ave, Tahlequah, OK 74464-3122 | 2019-05-20 |
| 1821562430 | Abigail Shaw | Case Manager/Care Coordinator | 1000 N Grand Ave Apt 57, Tahlequah, OK 74464-7063 | 2019-01-16 |
| 1033682794 | Samantha Lee Galentine | Case Manager/Care Coordinator | 14180 N Mandy Rd, Tahlequah, OK 74464-0658 | 2019-01-05 |
| 1508361726 | Beverly Jean Spriggs | Case Manager/Care Coordinator | 2006 White Ave, Tahlequah, OK 74464-5717 | 2018-03-28 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1205366499 | Jamie Leann Duffield | Case Manager/Care Coordinator | 274 Redbud Ln, Tahlequah, OK 74464-4913 | 2017-06-19 |
| 1427585439 | Shannon Dee Ann Sharp | Case Manager/Care Coordinator | 21977 Stick Ross Mountain Rd, Tahlequah, OK 74464-8064 | 2017-05-22 |
| Find all providers in TAHLEQUAH | ||||
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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.