KERRI JACOBS (NPI# 1184232241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184232241 |
| Entity Type | Individual |
| Full Name | KERRI JACOBS |
| Practice Address |
540 Illinois St Pawnee OK 74058-2036 |
| Mailing Address |
43500 S 356 Rd Pawnee OK 74058-4555 |
| Practice Telephone | 9187621045 |
| Mailing Telephone | 9182237694 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
540 ILLINOIS ST |
| City | PAWNEE |
| State | OK |
| Zip Code | 74058-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821275744 | Patsy Ann Cooper | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2008-01-22 |
| 1043855372 | Melissa Coleman | Case Manager/Care Coordinator | 540 Illinois St, Pawnee, OK 74058-2036 | 2019-11-11 |
| 1669016341 | Jo Lynn Strate | Social Worker | 540 Illinois St, Pawnee, OK 74058-2036 | 2019-11-05 |
| 1912561903 | Jerri Lynn Shaw | Peer Specialist | 540 Illinois St, Pawnee, OK 74058-2036 | 2019-04-25 |
| 1851808042 | Talena Gay Odell | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2018-01-09 |
| 1669989943 | Deanna Lynn Whitten | Case Manager/Care Coordinator | 540 Illinois St, Pawnee, OK 74058-2036 | 2018-01-08 |
| 1346767761 | Belinda Stubblefield | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2017-08-25 |
| 1821518614 | Bailey Reann Huckeby | Case Manager/Care Coordinator | 540 Illinois St, Pawnee, OK 74058-2036 | 2017-06-22 |
| 1447665187 | Laura Afton Edens | Registered Nurse | 540 Illinois St, Pawnee, OK 74058-2036 | 2014-06-20 |
| 1174933782 | Melissa Fleming | Social Worker | 540 Illinois St, Pawnee, OK 74058-2036 | 2014-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316214430 | Tonya L Houston | Nurse Practitioner | Pawnee Indian Health Center, 1201 Heritage Cir, Pawnee, OK 74058 | 2011-11-17 |
| 1659662153 | Christie Factor | Counselor | 540 Illinois, Pawnee, OK 74058 | 2011-05-02 |
| 1366476368 | Henry J Kaehler Jr Dds PC | Clinic/Center | 401 Forest St, Pawnee, OK 74058 | 2006-07-10 |
| 1003892621 | Brady Gene Englestead | Pediatrics | 1201 Heritage Circle, Pawnee, OK 74058 | 2005-12-15 |
| 1598039620 | Cah Acquisition Company 12 LLC | Clinic/Center | 535 6th St, Pawnee, OK 74058 | 2012-03-07 |
| 1659473080 | Henry John Kaehler Jr. | Dentist | 401 Forest St, Pawnee, OK 74058 | 2006-09-05 |
| 1578503611 | William Lester Carruth | Dentist | 481 Agency Road, Pawnee, OK 74058-0130 | 2006-06-07 |
| 1225158314 | Cockrell Eyecare Center | Optometrist | 534 Illinois St, Pawnee, OK 74058-2036 | 2007-03-30 |
| 1427192541 | Boss Medical, LLC | Durable Medical Equipment & Medical Supplies | 524 Illinois St, Pawnee, OK 74058-2036 | 2007-02-20 |
| 1659456978 | City of Pawnee | Ambulance | 510 Illinois St, Pawnee, OK 74058-2036 | 2006-10-26 |
| Find all providers in zip 74058 | ||||
| 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 |
|---|---|---|---|---|
| 1881246239 | Mee-kai Clark | Peer Specialist | 717 Boulder St, Pawnee, OK 74058-4035 | 2019-07-15 |
| 1912561903 | Jerri Lynn Shaw | Peer Specialist | 540 Illinois St, Pawnee, OK 74058-2036 | 2019-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
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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.