BOBBY DALE SIMMONS (NPI# 1184138059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184138059 |
| Entity Type | Individual |
| Full Name | BOBBY DALE SIMMONS |
| Practice Address |
921 Ne 16th St Oklahoma City OK 73104-4609 |
| Practice Telephone | 4055499772 |
| Mailing Telephone | 4055499772 |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
921 NE 16TH ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73104-4609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356979645 | Kayla Campbell | Dietitian, Registered | Stephenson Cancer Center, 800 Ne 10th Street, Oklahoma City, OK 73104 | 2020-03-31 |
| 1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
| 1265902340 | Jenna Lyn Celii | Registered Nurse | 920 Sl Young Blvd Ste 1140, Oklahoma City, OK 73104 | 2018-11-30 |
| 1407337462 | Opus Medical, LLC | Psychiatry & Neurology | 4 Ne 10th St Suite 467, Oklahoma City, OK 73104 | 2018-08-27 |
| 1316433295 | Syed Muhammad Shakaib Quadri | Pathology | 940 Stanton L. Young Blvd., Bmsb 451, Oklahoma City, OK 73104 | 2018-07-03 |
| 1447746417 | Nimrah Bader | Internal Medicine | 800 Stanton L. Young Blvd., Aat 6300, Oklahoma City, OK 73104 | 2018-07-02 |
| 1417440793 | Helen Judith Turkson Apetor | Nurse Practitioner | 700 Ne 13th, Oklahoma City, OK 73104 | 2018-06-11 |
| 1003307935 | Mary Katlin Nixon | Obstetrics & Gynecology | 800 Stanton L Young Blvd Ste 2319, Oklahoma City, OK 73104 | 2018-05-26 |
| 1558851220 | Bryce Yohannan | Student in an Organized Health Care Education/Training Program | 800 Stanton L Young Blvd, Aat 6300, Oklahoma City, OK 73104 | 2018-05-17 |
| 1346746690 | Kacy Anne Richburg | Orthopaedic Surgery | 711 Stanton L Young Blvd Ste 111, Oklahoma City, OK 73104 | 2018-04-04 |
| Find all providers in zip 73104 | ||||
| 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 | 73104 |
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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.