MR. DAVID TEAGUE SMITH (NPI# 1811408859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811408859 |
| Entity Type | Individual |
| Full Name | MR. DAVID TEAGUE SMITH |
| Practice Address |
1311 N Lottie Ave Oklahoma City OK 73117-2051 |
| Mailing Address |
1009 Ne 18th St Oklahoma City OK 73111-1007 |
| Practice Telephone | 4056003074 |
| Mailing Telephone | 4058357205 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | DRIVERS LISENSE | N081141606 | 01 |
| OK | N081141606 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1009 Ne 18th St, Oklahoma City, OK 731111007 | 4058357205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629678438 | David B Smith | Pharmacist | 369 Scotts Fork-bonnie Road, Sutton, WV 26601 | 2020-10-30 |
| 1861028235 | David J Smith | Counselor | 841 Central Ave N # C114, Kent, WA 98032-2016 | 2020-03-18 |
| 1306470406 | David Smith | Counselor | 556 Harvick Cir, Stockbridge, GA 30281-4460 | 2020-02-27 |
| 1740811322 | David Smith | Student in an Organized Health Care Education/Training Program | 1620 Belvedere Pl, Round Rock, TX 78665-5658 | 2020-01-31 |
| 1407320880 | David Smith | Physical Therapist | 774 Christiana Rd Ste 3, Newark, DE 19713-4219 | 2019-01-18 |
| 1982177481 | David Culver Smith | Counselor | 15739 Tambour Ct, Chesterfield, MO 63017-7224 | 2019-01-07 |
| 1053895557 | David Wayne Smith Jr. | Pharmacist | 4651 S Custer Rd Apt 2203, Mckinney, TX 75070-8113 | 2018-09-20 |
| 1295212959 | David Kevin Smith | Technician/Technologist | 10041 Us Highway 19, Port Richey, FL 34668-3785 | 2018-07-25 |
| 1326540279 | David Crawford Smith | Internal Medicine | 3260 Adams Rd, Sacramento, CA 95864-5059 | 2018-03-07 |
| 1508370198 | David Shane Smith | Counselor | 2485 Maryville Dr, Dubuque, IA 52001-1663 | 2017-11-19 |
| Street Address |
1311 N LOTTIE AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73117-2051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053749051 | James Roberts | Contractor | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2013-10-29 |
| 1104434638 | Clarence Russell Smith | Peer Specialist | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2020-07-21 |
| 1437659513 | Susan Morton Malloy | Student in an Organized Health Care Education/Training Program | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2018-02-15 |
| 1033656673 | Sara Meza | Peer Specialist | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2017-01-20 |
| 1316481583 | Ricky Bates | Technician, Other | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2016-12-07 |
| 1881052918 | Bianca Lorraine Thompson | Specialist/Technologist, Other | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2016-02-03 |
| 1689096729 | Megan Pruitt | Social Worker | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2014-01-08 |
| 1467880377 | Shundricka Love | Case Manager/Care Coordinator | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2013-10-31 |
| 1508294570 | Staci Willis | Case Manager/Care Coordinator | 1311 N Lottie Ave, Oklahoma City, OK 73117-2051 | 2013-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922623271 | Katelyn Gerth | Student in an Organized Health Care Education/Training Program | University of Oklahoma College of Medicine, 800 Stanton L. Young Blvd, Oklahoma City, OK 73117 | 2020-06-12 |
| 1114401387 | Northstar Counseling Associates, LLC | Counselor | 4540 E Reno Ave, Del City, OK 73117 | 2018-09-24 |
| 1801300710 | Kenneth Belyeu | Peer Specialist | 625 N Nebraska, Okc, OK 73117 | 2017-11-30 |
| 1215483029 | Brian Behnum Minavi | Dentist | 1201 N. Stonewall Ave., Oklahoma City, OK 73117 | 2016-08-31 |
| 1649631409 | April Ajanwachukwu | Social Worker | 1309 N Nebraska Ave, Oklahoma City, OK 73117 | 2016-03-08 |
| 1518340405 | Shachi Shah | Dentist | 1201 N Stonewall Ave # 544n, Oklahoma City, OK 73117 | 2015-07-09 |
| 1063829067 | Lauren Marie Pierce | Speech-Language Pathologist | 1200 N. Stonewall Ave, Ahb 1058, Oklahoma City, OK 73117 | 2014-07-22 |
| 1306195235 | Rachel Devecchio | Case Manager/Care Coordinator | 1300 Ne 13th St, Oklahoma City, OK 73117 | 2012-09-06 |
| 1265780837 | Tiffany Dawn Stokely | Counselor | 1701 E Park Pl, Oklahoma, OK 73117 | 2012-08-29 |
| 1689935645 | Everett House | Behavioral Analyst | 1100 Ne 15th St, Oklahoma Cituy, OK 73117 | 2012-06-06 |
| Find all providers in zip 73117 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002818 | Keegan Eisenhardt | Peer Specialist | 6405 S Villa Ave, Oklahoma City, OK 73159-2741 | 2020-08-05 |
| 1689283780 | Gregory Purvis Jr. | Peer Specialist | 1305 Parkwoods Ct, Oklahoma City, OK 73110-7425 | 2020-07-24 |
| 1609485762 | Amanda Elaine Cruz | Peer Specialist | 1605 Nw 30th St Apt 228, Oklahoma City, OK 73118-3622 | 2020-07-24 |
| 1063021384 | Christina Len Petty | Peer Specialist | 2144 Nw 29th St, Oklahoma City, OK 73107-2526 | 2020-07-23 |
| 1104443977 | Jennifer Lynn Cobb | Peer Specialist | 2400 General Pershing Blvd Apt 308, Oklahoma City, OK 73107-6429 | 2020-06-28 |
| 1801412135 | Cleborn Gossett | Peer Specialist | 721 Waterview Rd, Oklahoma City, OK 73170-1637 | 2020-06-23 |
| 1487270617 | Foxy S Starnes | Peer Specialist | 9008 N Shannon Ave, Oklahoma City, OK 73132-1142 | 2020-06-23 |
| 1154945582 | Alexandra Paige Mcgowan-rayburn | Peer Specialist | 4129 Nw 21st St, Oklahoma City, OK 73107-2607 | 2020-06-01 |
| 1962034504 | Crystal Rose Mckee | Peer Specialist | 3417 S Independence Ave, Oklahoma City, OK 73119-2617 | 2020-02-11 |
| 1508496662 | Brie Jordan Florence | Peer Specialist | 2640 Sw 95th St, Oklahoma City, OK 73159-6720 | 2020-01-16 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73117 |
Please comment or provide details below to improve the information on MR. DAVID TEAGUE SMITH.
| 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.