SAM NIMO (NPI# 1386190569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386190569 |
Entity Type | Individual |
Full Name | SAM NIMO |
Practice Address |
9210 S Western Ave Ste A-21 Oklahoma City OK 73139 |
Mailing Address |
8213 Nw 8th St Oklahoma City OK 73127-4811 |
Practice Telephone | 4057038755 |
Practice Fax Number | 4058957544 |
Mailing Telephone | 4054746466 |
Enumeration Date | 2016-08-29 |
Last Update Date | 2016-08-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
9210 S WESTERN AVE STE A-21 |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73139 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518242205 | Augustine I Uche | Counselor | 9210 S Western Ave Ste A-21, Oklahoma City, Oklahoma City, OK 73139-2734 | 2011-10-13 |
1174031827 | Leslie Allison Earl | Counselor | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2018-01-16 |
1598284713 | Alexander Gene Hixson I | Peer Specialist | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2017-09-19 |
1881112084 | Garfield Mordeci Bowen | Peer Specialist | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2017-09-07 |
1528593142 | Kim N Hunter | Counselor | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2017-04-21 |
1265883235 | Gabrielle Koch | Case Manager/Care Coordinator | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2016-06-30 |
1609266063 | Eric Zane Hatch | Case Manager/Care Coordinator | 9210 S Western Ave Ste A-21, Oklahoma City, OK 73139-4982 | 2015-01-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447899778 | First Med Primary Care LLC | Clinic/Center | 1142 Sw 104th St, Oklahoma City, OK 73139 | 2020-01-03 |
1205305737 | Transit Medical Team LLC | In Home Supportive Care | 1145 S I-240 Service Rd Ste F, Oklahoma City, OK 73139 | 2018-11-14 |
1336621770 | Mayra Edith Solis | Case Manager/Care Coordinator | 6510 S. Western Ave Bldg. 400, Oklahoma City, OK 73139 | 2018-09-01 |
1619470184 | Linzi L Stewart, D.o., P.l.l.c. | Obstetrics & Gynecology | 10400 S Western Ave Ste 7, Oklahoma City, OK 73139 | 2018-03-12 |
1467970467 | Oklahoma Healthcare Transitions Inc | Home Health | 6803 S Western Ave Ste 400, Oklahoma City, OK 73139 | 2017-08-30 |
1841714169 | Gentry Kyler Jones | Case Manager/Care Coordinator | 301 W I240 Service Rd, Oklahoma City, OK 73139 | 2017-07-28 |
1437688082 | Jasmine Small | Case Manager/Care Coordinator | 6100 S Walker, Okc, OK 73139 | 2017-06-07 |
1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
1225491343 | Elizabeth Pratt | Counselor | 301 Interstate 240 Service Rd, Oklahoma City, OK 73139 | 2016-04-05 |
1326418542 | Brittany Elis Walley | Case Manager/Care Coordinator | 8015 S Klein Ave, Oklahoma City, OK 73139 | 2015-09-30 |
Find all providers in zip 73139 |
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 | 73139 |
Please comment or provide details below to improve the information on SAM NIMO.
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.