ELMIRA LOUISE JOHNSON (NPI# 1326697459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326697459 |
| Entity Type | Individual |
| Full Name | ELMIRA LOUISE JOHNSON |
| Practice Address |
109 S Willow St Pauls Valley OK 73075-3833 |
| Mailing Address |
Po Box 635 Pauls Valley OK 73075-0635 |
| Practice Telephone | 4052387311 |
| Practice Fax Number | 4052383530 |
| Mailing Telephone | 4052074434 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |
| 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 |
109 S WILLOW ST |
| City | PAULS VALLEY |
| State | OK |
| Zip Code | 73075-3833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538248992 | Edward James Seeley | Counselor | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2006-11-04 |
| 1528667680 | Amy Holland | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2020-10-20 |
| 1174140883 | Michelle Elaine Rutherford | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2020-06-29 |
| 1538727136 | Sarah Marie Stone | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075 | 2019-05-30 |
| 1457916025 | Natasha Lynnette Green | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2019-05-08 |
| 1275007122 | Chelsea Ann Triplett | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2019-01-14 |
| 1528546629 | Vanessa Dale Cothren | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2018-07-31 |
| 1912423195 | Hannah Marie Maness | Case Manager/Care Coordinator | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2017-08-18 |
| 1437695947 | Kathlyn Milligan | Counselor | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2017-01-09 |
| 1740739606 | Ayla Rabecca Wood | Counselor | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2016-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292490 | Jennifer Lynn Reicosky | Counselor | 513 Willow, Pauls Valley, OK 73075 | 2018-10-25 |
| 1336467299 | Fred Lee Mcginn Iv | Counselor | Atlc, 111 Arrowhead Dr., Pauls Valley, OK 73075 | 2010-05-17 |
| 1447435433 | Amanda Marie Hammonds | Physical Therapist | 37915 Ecr 1530, Pauls Valley, OK 73075 | 2008-01-08 |
| 1255533873 | Ladonna L.l. Lynnell Luckey | Counselor | 111 Arrowhead Drive, Adolescent Transitional Living Center, Pauls Valley, OK 73075 | 2007-06-05 |
| 1144369026 | James Ray Ward | Dentist | 112 N Oak, Pauls Valley, OK 73075 | 2007-02-06 |
| 1700953247 | Stanley Family Chiropractic PC | Chiropractor | 1555 W Grant, Pauls Valley, OK 73075 | 2006-11-29 |
| 1659458412 | Woodlawn, LLC | Respite Care | 1413 S. Chickasha, Pauls Valley, OK 73075 | 2006-11-01 |
| 1689750457 | Dana J Martin Dds PC | Dentist | 1600 Airline Road, Pauls Valley, OK 73075 | 2006-10-27 |
| 1609963800 | State of Oklahoma Dept. of Human Services | Pharmacy | Rt 1 Box 44a, Pauls Valley, OK 73075 | 2006-10-07 |
| 1295828895 | State of Oklahoma Dept. of Human Services | Intermediate Care Facility, Mentally Retarded | Rt. 1 Box 44-a, Pauls Valley, OK 73075 | 2006-10-02 |
| Find all providers in zip 73075 | ||||
| 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 |
|---|---|---|---|---|
| 1528667680 | Amy Holland | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2020-10-20 |
| 1134585847 | Tamara Anderson | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2016-01-11 |
| 1275924516 | Steven Smith I | Peer Specialist | 109 S Willow St, Pauls Valley, OK 73075-3833 | 2015-02-09 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PAULS VALLEY |
| Zip Code | 73075 |
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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.