J CLYDE FRAZIER (NPI# 1538633565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538633565 |
| Entity Type | Individual |
| Full Name | J CLYDE FRAZIER |
| Practice Address |
6333 E Skelly Dr Tulsa OK 74135-6106 |
| Practice Telephone | 9186644224 |
| Mailing Telephone | 9186644224 |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2019-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OK | Other Service Providers |
| Street Address |
6333 E SKELLY DR |
| City | TULSA |
| State | OK |
| Zip Code | 74135-6106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053317883 | 12 & 12, Inc. | Substance Abuse Rehabilitation Facility | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2005-06-27 |
| 1720685175 | Jesse Misthaven | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-10-07 |
| 1699372482 | Christine Reynold | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-10-05 |
| 1679185920 | Kacey Ann Cottrell | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-08-18 |
| 1861003931 | Matthew Schane | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-08-12 |
| 1841817368 | Bernadette Bouciquot | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-30 |
| 1568088011 | Brenda Kay Kuntzelman | Licensed Practical Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-21 |
| 1023634698 | Kelli Ann Ordorica | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-19 |
| 1215552120 | Amanda Lindsey Spicer | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-16 |
| 1619592672 | Tieraney Candice Rodriguez | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761590 | Dr. Whitney M. Ellsworth, Dpt, Pllc | Physical Therapist | 4185 S Harvard Ave, Suite E-1, Tulsa, OK 74135 | 2020-08-20 |
| 1942839089 | Kimberly Renee Gillens | Student in an Organized Health Care Education/Training Program | 4502 E 41st Street Obgyn Department, Tulsa, OK 74135 | 2020-04-01 |
| 1528525524 | Everest Pain Management | Clinic/Center | 4134 S Harvard Ave Suite B1, Tulsa, OK 74135 | 2019-02-26 |
| 1326524216 | Shelley Deeann Anderson | Technician | 7359 S 68th, Tulsa, OK 74135 | 2018-07-14 |
| 1811489065 | Taylor Diane Spears | Behavioral Analyst | 4835 S Fulton Ave Suite 104, Tulsa, OK 74135 | 2018-06-04 |
| 1225547821 | Heather Nicole Freed | Counselor | 4363 S Harvard Ave, Tulsa, OK 74135 | 2017-09-26 |
| 1306363924 | Danielle Walker | Case Manager/Care Coordinator | 3244 S Lakewood Ave Apt 4e, Tulsa, OK 74135 | 2017-08-24 |
| 1346766078 | Angels Place | Day Training, Developmentally Disabled Services | 3919 S. Oswego Avenue, Tulsa, OK 74135 | 2017-08-15 |
| 1659800019 | Welena-phay Kamamma Boren | Counselor | 4636 S Harvard Avenue, Tulsa, OK 74135 | 2017-06-08 |
| 1346774197 | Brandie Herren | Registered Nurse | 6333 E Skelly Drive, Tulsa, OK 74135 | 2017-04-19 |
| Find all providers in zip 74135 | ||||
| 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 |
|---|---|---|---|---|
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1275131823 | Deena June Patrick | Peer Specialist | 2536 N Boston Ave, Tulsa, OK 74106-3609 | 2020-10-15 |
| 1760098248 | Eddie L Rodriguez | Peer Specialist | 3821 S Rolling Oaks Dr, Tulsa, OK 74107-4872 | 2020-09-20 |
| 1316553100 | Amber Ponder | Peer Specialist | 7802 W 7th St, Tulsa, OK 74127-5524 | 2020-09-17 |
| 1699380089 | Sunny Shirene Cooper | Peer Specialist | 9933 E 61st St, Tulsa, OK 74133-1504 | 2020-09-11 |
| 1669099875 | Denise Lyn Ely | Peer Specialist | 12 E 12th St, Tulsa, OK 74119-2803 | 2020-07-03 |
| 1831715945 | Kyndell Leigh Mcelwee | Peer Specialist | 5043 S 76th East Ave Apt B, Tulsa, OK 74145-6219 | 2020-06-24 |
| 1548886088 | Dana Kai Stevens | Peer Specialist | 2027 E 12th Pl, Tulsa, OK 74104-4201 | 2020-06-21 |
| 1932723251 | Andrew Jacob Sargent | Peer Specialist | 321 S Frankfort Ave, Tulsa, OK 74120-2428 | 2020-06-02 |
| 1114549656 | Jonathan Michael Holbrook | Peer Specialist | 6963 E 15th Pl Apt 239, Tulsa, OK 74112-7410 | 2020-05-06 |
| Find all providers in TULSA | ||||
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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.