MANDOLIN REANNA STEGALL (NPI# 1699229955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699229955 |
| Entity Type | Individual |
| Full Name | MANDOLIN REANNA STEGALL |
| Practice Address |
12005 E 470 Rd Claremore OK 74017-3737 |
| Practice Telephone | 9183420770 |
| Practice Fax Number | 9183420087 |
| Mailing Telephone | 9183420770 |
| Mailing Fax Number | 9183420087 |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-09-06 |
| 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 |
12005 E 470 RD |
| City | CLAREMORE |
| State | OK |
| Zip Code | 74017-3737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528090636 | Sheri Lyn Scott | Social Worker | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2006-07-07 |
| 1629677802 | Raechel Russo | Marriage & Family Therapist | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-10-20 |
| 1487252649 | Maci Ann French | Case Manager/Care Coordinator | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-10-10 |
| 1972120418 | Edelia Galvan | Case Manager/Care Coordinator | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-07-01 |
| 1861019895 | Tiffany Raychelle Shepherd | Case Manager/Care Coordinator | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-06-25 |
| 1720604200 | Elissa Mae Ericksen | Peer Specialist | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-06-22 |
| 1215551429 | Sophia Lefrere | Social Worker | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-06-03 |
| 1962025395 | Jill Raburn | Registered Nurse | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-05-20 |
| 1487274346 | Cheyenne Madison Akers | Case Manager/Care Coordinator | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-04-21 |
| 1962030445 | Dakota Ritchie | Case Manager/Care Coordinator | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763127 | Randye Knott | Physical Therapist | 99224 S. Brady St. Suite 109, Claremore, OK 74017 | 2020-06-08 |
| 1538794854 | Katie Ann Osburn | Peer Specialist | 12005 E 490 Rd, Claremore, OK 74017 | 2020-03-06 |
| 1174185144 | Jamie Lynn Bell | Dentist | 1222 N. Florence Ave, Claremore, OK 74017 | 2019-07-01 |
| 1508326877 | Cheri L Doyle | Social Worker | Foundation Behavioral Health, 1218 N Florence Ave Suite 1218b, Claremore, OK 74017 | 2019-03-22 |
| 1487144374 | Kimberly Gale Henry | Case Manager/Care Coordinator | 16305 E Grand Meadow Dr., Claremore, OK 74017 | 2018-05-16 |
| 1912449836 | Katie Jentry Greenwell | Case Manager/Care Coordinator | 423 N. Seminole, Claremore, OK 74017 | 2016-11-09 |
| 1598219347 | Spring Dental Claremore | Dentist | 504 S. Lynn Riggs Blvd., Ste #100, Claremore, OK 74017 | 2016-08-10 |
| 1811366701 | Alonna Adair-triplett | Registered Nurse | 101 S. Moore, Claremore, OK 74017 | 2015-09-21 |
| 1992135719 | Jordan Nicole Martin | Behavioral Analyst | 24797 Oklahoma 66, Claremore, OK 74017 | 2013-11-14 |
| 1992059398 | Wood Manor, Inc. | Alzheimer Center (Dementia Center) | 2800 N. Hickory, Claremore, OK 74017 | 2012-11-07 |
| Find all providers in zip 74017 | ||||
| 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 |
|---|---|---|---|---|
| 1538794854 | Katie Ann Osburn | Peer Specialist | 12005 E 490 Rd, Claremore, OK 74017 | 2020-03-06 |
| 1639701295 | Mckenzie D Mowery | Peer Specialist | 1402 N Choctaw Pl, Claremore, OK 74017-3114 | 2020-02-11 |
| 1912554676 | Kathryn Kidd | Peer Specialist | 306 N Davis Ave, Claremore, OK 74017-3447 | 2019-08-19 |
| 1659923241 | Melissa Renee Collins | Peer Specialist | 8130 E Silverado Rd, Claremore, OK 74019-7517 | 2019-07-12 |
| 1699327270 | Jacalyn Honeywell | Peer Specialist | 2000 Frederick Rd Apt A11, Claremore, OK 74019-1440 | 2019-07-12 |
| 1093276438 | Aubrey Loti Loti | Peer Specialist | 9748 E 530 Rd, Claremore, OK 74019-0370 | 2019-03-28 |
| 1649748260 | Leah Michelle Dewhitt | Peer Specialist | 11880 Laurel Ln, Claremore, OK 74017-3436 | 2018-11-13 |
| 1700354503 | Tasonda Michelle Kirby | Peer Specialist | 25145 S 4130 Rd, Claremore, OK 74019-0249 | 2018-11-09 |
| 1265908495 | Kevin Chambers | Peer Specialist | 112 E 13th Pl, Claremore, OK 74017-4207 | 2018-10-15 |
| 1295245280 | Nigel J Reynolds | Peer Specialist | 17250 E 394 Rd, Claremore, OK 74017-2902 | 2017-10-04 |
| Find all providers in CLAREMORE | ||||
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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.