COREY LAVON DEWBERRY (NPI# 1508128505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508128505 |
| Entity Type | Individual |
| Full Name | COREY LAVON DEWBERRY |
| Practice Address |
425 Fretz Ave Edmond OK 73003-5532 |
| Mailing Address |
2596 Lancaster Ct Apopka FL 32703-8138 |
| Practice Telephone | 4055096703 |
| Mailing Telephone | 4074859222 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
425 FRETZ AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73003-5532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043591266 | Jonathan Oglesby | Behavioral Analyst | 425 Fretz Ave, Edmond, OK 73003-5532 | 2011-09-01 |
| 1427310978 | Cynthia M Keiser | Clinic/Center | 425 Fretz Ave, Edmond, OK 73003-5532 | 2012-06-11 |
| 1568744563 | Ashley Lauren Mcintyre | Behavioral Analyst | 425 Fretz Ave, E & F, Edmond, OK 73003-5532 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945202 | Korbin Hally | Dentist | 2600 Tayler Street, Edmond, OK 73003 | 2020-06-04 |
| 1003448325 | Diagnostic Resources, LLC | Physical Medicine & Rehabilitation | 1641 Saratoga Way, Edmond, OK 73003 | 2020-02-05 |
| 1861904021 | Rhonda Diane Pennington | Occupational Therapist | 515 S Santa Fe Ave Ste 103, Edmond, OK 73003 | 2017-10-27 |
| 1588173744 | Hpc Holdings LLC | Clinic/Center | 813 W Covell Rd, Edmond, OK 73003 | 2017-09-20 |
| 1194243568 | Nightengale Chiropractic, LLC | Chiropractor | 2616 Covell Village Dr Ste. 120, Edmond, OK 73003 | 2017-09-06 |
| 1104274927 | Bonsu Osei Asibey | Case Manager/Care Coordinator | 1301 Craig Blvd, Edmond, OK 73003 | 2016-06-02 |
| 1215390810 | Prince Yebo | Case Manager/Care Coordinator | 1817 Redland Dr, Edmond, OK 73003 | 2016-03-31 |
| 1548621691 | Charles Loftis | Physical Therapist | 1321 Fretz Drive, 100, Edmond, OK 73003 | 2016-03-17 |
| 1487013801 | Courage Counseling Center | Community/Behavioral Health | 1400 S. Fretz Ave, Suite 1400, Edmond, OK 73003 | 2016-02-12 |
| 1669889887 | Shannon Gogel | Occupational Therapy Assistant | 1309 Val Genes Rd, Edmond, OK 73003 | 2014-07-21 |
| Find all providers in zip 73003 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194202143 | Cutshall Counseling, LLC | Clinic/Center | 417 W 18th St Ste 103, Edmond, OK 73013-3692 | 2018-07-23 |
| 1689092850 | Cassandra Seward | Clinic/Center | 17408 Durbin Park Rd, Edmond, OK 73012-6912 | 2014-04-03 |
| 1497179428 | Recovery Achievements LLC | Clinic/Center | 400 S Broadway # 15, Edmond, OK 73034-3848 | 2014-02-11 |
| 1407103146 | Hearts of Hope LLC | Clinic/Center | 400 S Broadway Ste 9, Edmond, OK 73034-3848 | 2012-08-13 |
| 1326310186 | Jami Mcgee | Clinic/Center | 1729 Louis Scott St, Edmond, OK 73003-3859 | 2012-02-08 |
| 1982984027 | Robbie Lowery | Clinic/Center | 1812 Nw 145th St, Edmond, OK 73013-1745 | 2011-08-21 |
| 1619577145 | Mathew David Riddle | Clinic/Center | 13707 Fairhill Ave, Edmond, OK 73013-1946 | 2020-10-26 |
| 1821696758 | Jodi Nunn | Clinic/Center | 13707 Fairhill Ave, Edmond, OK 73013-1946 | 2020-10-13 |
| 1336755313 | Kendra Bailey | Clinic/Center | 13707 Fairhill Ave, Edmond, OK 73013-1946 | 2020-09-16 |
| 1700492774 | Shannon Lee Digiovanni | Clinic/Center | 13707 Fairhill Ave, Edmond, OK 73013-1946 | 2020-09-16 |
| Find all providers in EDMOND | ||||
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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.