KEITH COCKLE


Address: 1115 Harbor Rd, Grove, OK 74344-3505
Phone: 9187864434

KEITH COCKLE (NPI# 1376908962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376908962
Entity Type Individual
Full Name KEITH COCKLE
Practice Address 1115 Harbor Rd
Grove
OK 74344-3505
Practice Telephone 9187864434
Practice Fax Number 9187864435
Mailing Telephone 9187864434
Mailing Fax Number 9187864435
Enumeration Date 2015-12-23
Last Update Date 2017-04-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist 129951 OK Other Service Providers

Office Location

Street Address 1115 HARBOR RD
City GROVE
State OK
Zip Code 74344-3505

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063429181 Grand Lake Mental Health Center, Inc. Clinic/Center 1115 Harbor Rd, Grove, OK 74344-3505 2006-08-02
1669084620 Deanna M Duvall Social Worker 1115 Harbor Rd, Grove, OK 74344-3505 2020-08-20
1558979831 Amber Rae Coker Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-07-22
1275157166 Katharine Jean Downing Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-06-05
1205464997 Kristen Bartz Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-03-30
1144853631 Jennifer Elizabeth Bowerman Peer Specialist 1115 Harbor Rd, Grove, OK 74344-3505 2020-02-13
1427697747 Grand Lake Mental Health Center, Inc. Clinic/Center 1115 Harbor Rd, Grove, OK 74344-3505 2020-01-03
1598302572 Shelbi Ann Brock Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2019-12-09
1447896907 Jennifer Lynne Andrews Registered Nurse 1115 Harbor Rd, Grove, OK 74344-3505 2019-11-20
1497399331 Steven Graham Shackelford Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2019-11-04
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326604935 Deborah Stauss Massage Therapist 2086 S Main St, Grove, OK 74344 2019-05-20
1841776705 Progressive Orthotic & Prosthetic Services, Inc Prosthetic/Orthotic Supplier 10 E 6th St., Grove, OK 74344 2018-07-13
1205329232 Andra Renee Mitchell Speech-Language Pathologist 825 E Third Street, Grove, OK 74344 2018-06-13
1861996217 Jenniffer Colleen Clark I Case Manager/Care Coordinator 1115 Har-ber Rd, Grove, OK 74344 2018-03-21
1417458167 Jason S Beckham Case Manager/Care Coordinator 32600 S. 625 Road, Grove, OK 74344 2018-02-27
1659872034 Keli Elaine Whitlock Peer Specialist 5602 Us Hwy 59, Grove, OK 74344 2018-02-22
1851899454 Nichole Marie Wooton Case Manager/Care Coordinator 1115 Har-ber Road, Grove, OK 74344 2018-01-29
1043766645 Samantha Lane Speech-Language Pathologist 1046 Hillside Road, Grove, OK 74344 2016-09-01
1376927509 Matthew Kyle Allen Physical Therapy Assistant 4621 Hwy 59 N, Grove, OK 74344 2015-07-17
1477807428 Andrew Scott Littlejohn Physical Therapy Assistant 103 Harber Road, Grove, OK 74344 2012-10-30
Find all providers in zip 74344

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144854654 William A Richards IIi Peer Specialist 201 Anchor Ln, Grove, OK 74344-5401 2020-02-24
1477193928 Brandon Yeager Peer Specialist 61024 E 246 Rd, Grove, OK 74344-0153 2020-01-13
1437629235 Elizabeth Scott Peer Specialist 60405 E 252 Ln, Grove, OK 74344-7786 2018-12-05
1356826861 Angela Littlejohn Peer Specialist 1115 S Harbor Rd, Grove, OK 74344-7918 2018-10-01
1760966071 William Sievert Peer Specialist 425 Chopper Ct, Grove, OK 74344-3351 2018-09-21
1407350580 Heath Adam Smith Peer Specialist 4602 Us Highway 59, Grove, OK 74344-4229 2018-03-22
1659872034 Keli Elaine Whitlock Peer Specialist 5602 Us Hwy 59, Grove, OK 74344 2018-02-22
1144853631 Jennifer Elizabeth Bowerman Peer Specialist 1115 Harbor Rd, Grove, OK 74344-3505 2020-02-13
1174182232 Jeffery Alan Forbes Peer Specialist 32300 S 625 Rd, Grove, OK 74344-6285 2019-06-11
1477022044 Lundi Brook Brickey Peer Specialist 1115 S. Harber Road, Grove, OK 74344-7918 2018-11-13
Find all providers in GROVE

Competitor

Search similar providers

City GROVE
Zip Code 74344

Improve Information

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Dataset Information

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.

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