JESSICA RANDOLPH (NPI# 1174842215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174842215 |
| Entity Type | Individual |
| Full Name | JESSICA RANDOLPH |
| Practice Address |
205 S. Jt Stites Sallisaw OK 74955-9301 |
| Mailing Address |
205 S. Jt Stites Sallisaw OK 74955 |
| Practice Telephone | 9187757787 |
| Mailing Telephone | 9187757787 |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2010-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275191074 | Jessica Randolph | Nurse Practitioner | 5965 E Broad St Ste 200, Columbus, OH 43213-1562 | 2019-06-05 |
| 1053788000 | Jessica Vernola Randolph | Podiatrist | 4921 E Bell Rd Ste 205, Scottsdale, AZ 85254 | 2015-08-25 |
| 1669877262 | Jessica Randolph | Case Manager/Care Coordinator | 7107 W 12th St, Suite 201, Little Rock, AR 72204-2404 | 2014-10-27 |
| 1073954400 | Jessica Luanne Randolph | Nurse Practitioner | 438 N Whitney Ave, Cookeville, TN 38501 | 2013-07-14 |
| 1447487301 | Jessica Dionne Randolph | Ophthalmology | 401 N 11th St, Richmond, VA 23219-1901 | 2009-06-18 |
| 1285754366 | Jessica Lynn Randolph | Counselor | 201 I U Willets Rd, Vocational Evaluation, Albertson, NY 11507-1516 | 2007-03-30 |
| Street Address |
205 S. JT STITES |
| City | SALLISAW |
| State | OK |
| Zip Code | 74955-9301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437418720 | Joseph Charles Hatfield | Counselor | 205 S. Jt Stites, Sallisaw, OK 74955 | 2012-05-08 |
| 1831491927 | Brooke Thompson | Counselor | 205 S. Jt Stites, Sallisaw, OK 74955 | 2010-11-23 |
| 1093035800 | Destry Dobbs | Counselor | 205 S. Jt Stites, Sallisaw, OK 74955-9301 | 2010-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057297 | Audrey A. Martin | Technician | 463508 East 1044 Road, Sallisaw, OK 74955 | 2019-11-12 |
| 1013472356 | Christopher Alan Bush | Registered Nurse | 301 Jt Stites, Sallisaw, OK 74955 | 2019-01-31 |
| 1174098941 | Sequoyah County Drug Company Pllc | Pharmacy | 1632 S Kerr Blvd, Sallisaw, OK 74955 | 2018-10-09 |
| 1720570609 | Stephanie Choate | Registered Nurse | 2703 E Phillips Ave, Sallisaw, OK 74955 | 2018-06-05 |
| 1972964666 | Sallisaw Family Medicine, L.L.C. | Family Medicine | 104 South Oak St, Sallisaw, OK 74955 | 2016-03-09 |
| 1407258544 | Mika Goff | Counselor | 301 So. Jt Stites, Sallisaw, OK 74955 | 2014-09-19 |
| 1013348200 | Alton Matlock | Counselor | 2101 Winter Park Drive, Apt/suite, Sallisaw, OK 74955 | 2013-12-12 |
| 1881931509 | Wildhorse Family Practice & Urgent Care | Clinic/Center | 1024 W Cherokee, Sallisaw, OK 74955 | 2013-01-15 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| Find all providers in zip 74955 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740656115 | Susan Smith | Counselor | 108089 S 4670 Rd, Sallisaw, OK 74955-8587 | 2015-08-19 |
| 1619383783 | Miriam Wall | Counselor | 205 S J T Stites, Sallisaw, OK 74955-9301 | 2014-07-09 |
| 1013348200 | Alton Matlock | Counselor | 2101 Winter Park Drive, Apt/suite, Sallisaw, OK 74955 | 2013-12-12 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1497005755 | Johnny Dale Dority I | Counselor | 907 S Walnut St, Sallisaw, OK 74955-6841 | 2012-09-14 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| 1124391859 | Jarrod Neal James | Counselor | 205 South J.t. Stites, Sallisaw, OK 74955 | 2012-02-10 |
| 1407160195 | Sarah Brook Jackson | Counselor | Hc 61 Box 272-4, Sallisaw, OK 74955-9440 | 2010-08-05 |
| 1164741583 | June Flute | Counselor | 1117 Brown St., Sallisaw, OK 74955 | 2010-05-25 |
| 1659690121 | Melinda Oneal | Counselor | 702 E Mary, Sallisaw, OK 74955 | 2010-05-24 |
| Find all providers in SALLISAW | ||||
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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.