KENDRA LAUDERDALE (NPI# 1912116005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912116005 |
| Entity Type | Organization |
| Organization Name | KENDRA LAUDERDALE |
| Practice Address |
2619 N Harvey Ave Oklahoma City OK 73103-3017 |
| Mailing Address |
9115 Shartel Ave Oklahoma City OK 73114-2803 |
| Practice Telephone | 4055253959 |
| Mailing Telephone | 4056057793 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | MS. DOROTHY R SHOEMAKER (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4054250385 |
| Authorized Official Credential | LCDW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
2619 N HARVEY AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73103-3017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750508313 | Kia Scales | Counselor | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2007-04-18 |
| 1477150530 | Red Rock Behavioral Health | Lodging | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2020-10-02 |
| 1134509565 | Veloria Harris | Licensed Practical Nurse | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2015-06-01 |
| 1275927006 | Jodi Parks | Day Training/Habilitation Specialist | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2015-03-18 |
| 1497178073 | Mark Pattillo | Counselor | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2014-02-01 |
| 1184063372 | Axton Tyler Nichols | Counselor | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2013-06-20 |
| 1427314517 | Latosha Marthia Jackson | Counselor | 2619 N Harvey Ave, Oklahoma City, OK 73103 | 2012-04-03 |
| 1003180852 | Kyle Matthew Hirsch | Case Manager/Care Coordinator | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2012-02-25 |
| 1700068558 | Ty Marshall Beasley | Social Worker | 2619 N Harvey Ave, Oklahoma City, OK 73103-3017 | 2007-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568946846 | Medical Center Pain Clinic, LLC | Pain Medicine | 1226 N Shartel Ave Suite 300, Oklahoma City, OK 73103 | 2018-09-21 |
| 1801321369 | Jessica Reed | Community Health Worker | 432 Nw11th St, Oklahoma City, OK 73103 | 2017-04-21 |
| 1982070975 | Retinal Care Diagnostics LLC | Ophthalmology | 1111 N Lee Ave Ste 210, Oklahoma City, OK 73103 | 2015-08-13 |
| 1316329063 | Nurturing Positive Solutions | Marriage & Family Therapist | 307 N. W. 21st Street, Oklahoma City, OK 73103 | 2015-06-18 |
| 1871916700 | Good Shepherd Ministries | Clinic/Center | 222 Nw 12th Street, Oklahoma City, OK 73103 | 2014-01-29 |
| 1275973448 | Christine Donnette Jeffers | Case Manager/Care Coordinator | 433 Nw 25 #10, Oklahoma, OK 73103 | 2013-07-02 |
| 1629327358 | Kelly Rose Whelan | Social Worker | 416 Nw 23rd St, Oklahoma City, OK 73103 | 2012-09-10 |
| 1801160585 | Susan Elizabeth Bigbie | Registered Nurse | 1214 N Hudson, Oklahoma City, OK 73103 | 2012-02-28 |
| 1548533441 | Doris Gayle Poteet | Licensed Practical Nurse | 1214 N. Hudson, Oklahoma, OK 73103 | 2012-02-23 |
| 1538440698 | Wendi J Rollins | Case Manager/Care Coordinator | 600 Nw 23, Suite 108, Oklahoma City, OK 73103 | 2011-09-02 |
| Find all providers in zip 73103 | ||||
| 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 |
|---|---|---|---|---|
| 1508467994 | Yenth Matilde Chaidez | Case Manager/Care Coordinator | 10409 Casa Linda, Oklahoma City, OK 73139-5510 | 2020-11-03 |
| 1760082523 | Alimot Shadia L Karim | Case Manager/Care Coordinator | 1330 N Classen Blvd Ste 314, Oklahoma City, OK 73106-6834 | 2020-10-29 |
| 1336749852 | Reshanna Leshae Childs-russell | Case Manager/Care Coordinator | 10505 Windway Ave, Oklahoma City, OK 73162-8001 | 2020-10-26 |
| 1770182065 | Ifeoluwa Ochuwa Idode | Case Manager/Care Coordinator | 8135 Bigwood Drive, Oklahoma City, OK 73135 | 2020-10-19 |
| 1689281180 | Michael Antem Abane | Case Manager/Care Coordinator | 11018 N May Ave Apt 218, Oklahoma City, OK 73120-6310 | 2020-09-28 |
| 1932715091 | Robyn Olukaikpe | Case Manager/Care Coordinator | 1736 Ne 14th St, Oklahoma City, OK 73117-3616 | 2020-09-23 |
| 1720694961 | Latasha Howell | Case Manager/Care Coordinator | 2416 Nw 12th St, Oklahoma City, OK 73107-5608 | 2020-09-22 |
| 1982218822 | Sybril Renee Jeffery | Case Manager/Care Coordinator | 8700 Sw 39th St, Oklahoma City, OK 73179-3878 | 2020-09-08 |
| 1871106096 | Harmonious Healing Counseling, LLC | Case Manager/Care Coordinator | 10802 Quail Plaza Dr Ste 205, Oklahoma City, OK 73120-3121 | 2020-08-27 |
| 1407466816 | Stephanie Denise Hollier | Case Manager/Care Coordinator | 1126 Nw 81st St, Oklahoma City, OK 73114-1811 | 2020-08-01 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73103 |
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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.