BRENT BRANHAM (NPI# 1780155945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780155945 |
| Entity Type | Individual |
| Full Name | BRENT BRANHAM |
| Practice Address |
11601 W Stanley Draper Dr Oklahoma City OK 73165-6503 |
| Mailing Address |
1940 Linwood Blvd Oklahoma City OK 73106-2628 |
| Practice Telephone | 4058020694 |
| Mailing Telephone | 4052321864 |
| Mailing Fax Number | 4057997528 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| 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 |
11601 W STANLEY DRAPER DR |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73165-6503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275961153 | Jacqueline Ann Falkner | Social Worker | 10231 Schwartz Drive, Oklahoma City, OK 73165 | 2013-10-31 |
| 1659624583 | Dewayne Williams | Social Worker | 5816 Se 144th St, Oklahoma City, OK 73165 | 2012-10-16 |
| 1407054018 | Carrie Matthews | Occupational Therapy Assistant | 3030 Nw Expwy Suite # 809, Okc, OK 73165 | 2007-07-05 |
| 1588096598 | Kimberly Michelle Marshall | Behavioral Analyst | 14708 Almond Valley Dr, Oklahoma City, OK 73165-1416 | 2013-07-31 |
| 1508316530 | Shayniel Stears | Physician Assistant | 16201 Gossamer Way, Oklahoma City, OK 73165-1503 | 2016-10-13 |
| 1427614536 | Katie Marie Zink | Case Manager/Care Coordinator | 12875 Willow Bay Dr, Oklahoma City, OK 73165-3201 | 2019-05-14 |
| 1386943520 | Emily Nicole Wise | Counselor | 13637 Se 94th St, Oklahoma City, OK 73165-4633 | 2011-03-25 |
| 1437700747 | Kay Tollefson | Technician | 12770 Se 149th St, Oklahoma City, OK 73165-6701 | 2019-09-27 |
| 1649681131 | Ollivett Brothers | Behavioral Analyst | 15811 Karen Dr, Oklahoma City, OK 73165-6784 | 2014-05-19 |
| 1689106114 | Faye Wilson | Case Manager/Care Coordinator | 6901 Se 162nd St, Oklahoma City, OK 73165-6849 | 2017-04-03 |
| Find all providers in zip 73165 | ||||
| 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 | 73165 |
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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.