PETER MATTHEW MAHAN (NPI# 1770034985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770034985 |
| Entity Type | Individual |
| Full Name | PETER MATTHEW MAHAN |
| Practice Address |
2821 Mustang Trl Edmond OK 73012-6688 |
| Practice Telephone | 4058595336 |
| Mailing Telephone | 4058595336 |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
2821 MUSTANG TRL |
| City | EDMOND |
| State | OK |
| Zip Code | 73012-6688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851778252 | Penny Lynn Willoughby | Counselor | 2821 Mustang Trl, Edmond, OK 73012-6688 | 2015-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013912 | Ashley Lambert | Counselor | 19501 N Pennsylvia, Apt 210, Edmond, OK 73012 | 2020-08-13 |
| 1699316083 | First Rate Eye Care Pllc | Optometrist | 1140 Nw 192nd St., Suite A, Edmond, OK 73012 | 2019-10-07 |
| 1659869881 | Brent Byers | Registered Nurse | 3040 Nw 179th Ct, Edmond, OK 73012 | 2018-04-24 |
| 1386173672 | John A Hale | Respiratory Therapist, Certified | 19100 Meadows Crossing Drive, Edmond, OK 73012 | 2017-06-08 |
| 1740715598 | Ryan Hays | Counselor | 620 Nw 178 St., Apt. 4c, Edmond, OK 73012 | 2017-04-28 |
| 1245691336 | Jessica Collins | Behavioral Analyst | 18217 Sandhurst Ct, Edmond, OK 73012 | 2016-03-16 |
| 1538545801 | Cynthia Ann Thompson | Case Manager/Care Coordinator | 1732 Kelly, Edmond, OK 73012 | 2015-08-10 |
| 1538564224 | Function Physical Therapy, LLC | Physical Therapist | 16502 N Pennsylvania Ave, Suite C, Edmond, OK 73012 | 2014-10-24 |
| 1003227414 | Deer Creek Family Healthcare and Wellness Clinic LLC | Clinic/Center | 19401 N. Portland, Edmond, OK 73012 | 2014-05-20 |
| 1316383649 | Ralphs Family Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Nw178th Street, Suite A, Edmond, OK 73012 | 2013-05-14 |
| Find all providers in zip 73012 | ||||
| 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 |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1417599085 | Jacob Oliver Buchanan | Case Manager/Care Coordinator | 4100 Nw 155th St, Edmond, OK 73013-9139 | 2019-10-15 |
| 1154963866 | Ericka Kennedy | Case Manager/Care Coordinator | 14117 Mount Vernon Pl, Edmond, OK 73013-6455 | 2019-10-14 |
| 1265073936 | Nick Edward Cole | Case Manager/Care Coordinator | 5200 E Sorghum Mill Rd, Edmond, OK 73034-9446 | 2019-10-03 |
| 1083268213 | Lyndsey Stewart | Case Manager/Care Coordinator | 1504 Canary Pl, Edmond, OK 73034-6115 | 2019-07-25 |
| 1922669639 | Flavio Vital | Case Manager/Care Coordinator | 157 Stonebridge Blvd Apt 1325, Edmond, OK 73013-4685 | 2019-06-24 |
| 1861056889 | Latasha Langley | Case Manager/Care Coordinator | 501 W 15th St Apt 171, Edmond, OK 73013-3654 | 2019-04-24 |
| 1962960732 | Amy Reynolds | Case Manager/Care Coordinator | 529 Cinnamon Dr, Edmond, OK 73003-3119 | 2019-03-11 |
| 1285198721 | Antonio De'shawn Johnson | Case Manager/Care Coordinator | 400 S Broadway Ste 6, Edmond, OK 73034-3848 | 2019-01-29 |
| 1356814701 | Kimley Deutsch | Case Manager/Care Coordinator | 518 W 2nd St, Edmond, OK 73003-5418 | 2019-01-08 |
| Find all providers in EDMOND | ||||
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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.