LISA MARIE HIDDLESTON (NPI# 1518597632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518597632 |
| Entity Type | Individual |
| Full Name | LISA MARIE HIDDLESTON |
| Practice Address |
8501 Nw Madische Rd Lawton OK 73507-1221 |
| Mailing Address |
3333 Sw 22nd St Oklahoma City OK 73108-4249 |
| Practice Telephone | 5804923614 |
| Mailing Telephone | 4058249170 |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |
| 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 |
8501 NW MADISCHE RD |
| City | LAWTON |
| State | OK |
| Zip Code | 73507-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528602505 | Robert Hausman | Case Manager/Care Coordinator | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2019-11-01 |
| 1871123406 | Timothy Leroy Parker Jr. | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-23 |
| 1780224907 | Michael Alan Lorentz I | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-15 |
| 1689214892 | John Fitzgerald Woosypiti | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-15 |
| 1932749157 | Manolito Jose Portillo II | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-15 |
| 1376183665 | Daniel Earl Smith | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-14 |
| 1548800907 | Winrod Yackeschi Red Elk | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-13 |
| 1689214132 | Devin Eli Toahty | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-13 |
| 1104465509 | Christine A Machado | Peer Specialist | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2020-01-02 |
| 1538703533 | Ricardo Isidoro Flores | Case Manager/Care Coordinator | 8501 Nw Madische Rd, Lawton, OK 73507-1221 | 2019-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720619935 | Kori Wren Wiegmann | Registered Nurse | 1515 Nw Lawrie Tatum Road, Lawton, OK 73507 | 2020-01-28 |
| 1013424027 | Liane Jacobson | Registered Nurse | 1515 Laurie Tatum Road, Adult Care Clinic 2, Lawton, OK 73507 | 2017-12-29 |
| 1649727041 | Rachel Ayala | Dietitian, Registered | 2811 Nw Hilltop Dr, Lawton, OK 73507 | 2016-09-02 |
| 1811370471 | William S, Davies, M.d., Inc. | Psychiatric Residential Treatment Facility | 1302 N, W, Lake Ave, Lawton, OK 73507 | 2015-07-01 |
| 1538554894 | Ashlee A Haugen-lewis | Behavioral Analyst | 4121 W Gore, Lawton, OK 73507 | 2015-04-03 |
| 1003188970 | Jenny Rae Mohon | Registered Nurse | 1515 North East Lawrie Tatum Road, Usphs Lawton Indian Hospital, Lawton, OK 73507 | 2012-02-07 |
| 1558548578 | Dawn M Griffith | Registered Nurse | 1515 Lawrie Tatum Dr., Lawton, OK 73507 | 2008-01-22 |
| 1275605172 | Judy Weiss | Pharmacist | 524 Lawrie Tatum Rd, Lawton, OK 73507 | 2006-11-15 |
| 1790895894 | William Spalding Davies | Psychiatry & Neurology | 1302 Lake Ave, Lawton, OK 73507 | 2006-08-30 |
| 1275646374 | Phillip Lynn Aday | Dentist | 1116 Nw Arlington, Lawton, OK 73507 | 2006-08-16 |
| Find all providers in zip 73507 | ||||
| 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 |
|---|---|---|---|---|
| 1134755812 | Tracy Marie Poafpybittty | Peer Specialist | 4904 Se Tattershall Way, Lawton, OK 73501-6400 | 2020-03-13 |
| 1932739935 | Paula Jean Cooper | Peer Specialist | 905 Sw 16th St, Lawton, OK 73501-4828 | 2020-01-19 |
| 1366072332 | Cheyenne Prettyflower Warner | Peer Specialist | 203 Sw 23rd Pl, Lawton, OK 73505-7125 | 2020-01-18 |
| 1699315408 | Ronald Dean Ramos I | Peer Specialist | 584 Nw Bingo Rd, Lawton, OK 73507-1214 | 2020-01-09 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1740639780 | Michael Alexander Watson | Peer Specialist | 6843 Nw Willow Springs Dr, 1211 Sw F Ave, Lawton, OK 73505-4251 | 2016-06-10 |
| 1821470410 | Rachel Marchbanks | Peer Specialist | 3606 Ne Willow Way, Lawton, OK 73507-4200 | 2015-06-19 |
| 1972995462 | Christian Lasiter | Peer Specialist | 1505 Sw 11th St Apt B4, Lawton, OK 73501-7376 | 2015-02-20 |
| 1811504145 | Renee Sosebee | Peer Specialist | 602 Sw 38th St, Lawton, OK 73505-6912 | 2020-09-30 |
| 1679180970 | Latricia Murphy | Peer Specialist | 602 Sw 38th St, Lawton, OK 73505-6912 | 2020-09-30 |
| Find all providers in LAWTON | ||||
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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.