JAMES RICHARD BROCK (NPI# 1801306022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801306022 |
| Entity Type | Individual |
| Full Name | JAMES RICHARD BROCK |
| Practice Address |
405 E Excelsior Ave Vinita OK 74301-4226 |
| Practice Telephone | 9182566476 |
| Practice Fax Number | 9182563628 |
| Mailing Telephone | 9182566476 |
| Mailing Fax Number | 9182563628 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912036823 | James Murray Brock Jr. | Dermatology | 136 Marion Ave, Mccomb, MS 39648-3620 | 2007-03-05 |
| 1316034754 | James Lee Brock | Technician/Technologist | 108 W George St, Arcanum, OH 45304-1109 | 2006-10-06 |
| 1750485850 | James Vaughn Brock Jr. | Psychologist | Dougherty Counseling Center, 1919 State St., Ste. #2, New Albany, IN 47150 | 2006-09-11 |
| 1790711711 | James Brock | Obstetrics & Gynecology | 3686 Grandview Pkwy Ste 320, Birmingham, AL 35243-3404 | 2006-06-23 |
| 1871133660 | James Brock | Behavior Technician | 1801 Excise Ave Ste 116, Ontario, CA 91761-8557 | 2020-01-09 |
| 1164071734 | James M Brock | Peer Specialist | 2803 Old North Hills St, Meridian, MS 39305-1630 | 2019-09-06 |
| 1427613520 | James Brock | Case Manager/Care Coordinator | 2347 Vine St, Cincinnati, OH 45219-1745 | 2019-05-03 |
| 1427520493 | James Albert Brock IIi | Anesthesiology | 3104 Blue Lake Dr Ste 110, Vestavia, AL 35243-2372 | 2019-01-01 |
| 1871859611 | James Philip Brock | Pediatrics | 2801 Atlantic Ave, Peds Pulmonary, Long Beach, CA 90806 | 2012-04-05 |
| 1073742607 | James Benjamin Brock | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2009-07-02 |
| Street Address |
405 E EXCELSIOR AVE |
| City | VINITA |
| State | OK |
| Zip Code | 74301-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710994835 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2006-08-02 |
| 1023625563 | Steven Ray Coatney | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-09-29 |
| 1932712775 | Karen Tiscareno | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-30 |
| 1669085528 | Felicia Johnson | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-28 |
| 1508474982 | Kari West | Case Manager/Care Coordinator | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-07-21 |
| 1770108920 | India Leigh Uhlemeyer | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-06-13 |
| 1356964399 | Allison L Andrasko | Registered Nurse | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-05-26 |
| 1861013070 | Chad H Wiens | Registered Nurse | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-04-28 |
| 1154940005 | Lisa R Farbro | Case Manager/Care Coordinator | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-04-10 |
| 1215569413 | Laytin Allen Parker | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740786 | Jennifer Lynn Black | Registered Nurse | 24919 S 4420 Road, Vinita, OK 74301 | 2020-11-03 |
| 1720686272 | Chancie Marie Cooper | Case Manager/Care Coordinator | 444 737 Hwy 28, Vinita, OK 74301 | 2020-10-15 |
| 1265082515 | Ruth Irving | Technician | 843 North Miller, Vinita, OK 74301 | 2019-09-18 |
| 1952897449 | Sarah Renee Gilmore | Behavior Technician | 526 N. Brewer, Vinita, OK 74301 | 2018-07-08 |
| 1134664683 | Sheila Mason | Nurse Practitioner | Department of Veterans Affairs Clinic, 269 South 7th Street, Vinita, OK 74301 | 2016-12-19 |
| 1881145274 | Saint Francis Hospital Vinita, Inc | Clinic/Center | 711 North Brewer Street, Vinita, OK 74301 | 2016-10-20 |
| 1699147249 | Beth Powell | Peer Specialist | 405 East Excelsior Ave, Vinita, OK 74301 | 2015-10-22 |
| 1790196202 | Peter Rausch | Psychologist | 735 N. Foreman St., Vinita, OK 74301 | 2014-05-19 |
| 1548605041 | Anita Joy Cantrell | Counselor | 1520 North Industrial Ave, Vinita, OK 74301 | 2013-05-10 |
| 1033469606 | Matt Lance Oldacre | Pharmacist | 525 S. Wilson, Vinita, OK 74301 | 2012-09-11 |
| Find all providers in zip 74301 | ||||
| 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 |
|---|---|---|---|---|
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1174174130 | Gloria Grace Ojeda | Peer Specialist | 111 W Halsell Ave, Vinita, OK 74301-2221 | 2019-09-21 |
| 1760969687 | Yvette Gayle Hacker | Peer Specialist | 448542 E 280 Rd, Vinita, OK 74301-6610 | 2018-07-24 |
| 1891289021 | Hannah Maurica Smith | Peer Specialist | 442075 E 250 Rd, Vinita, OK 74301-5218 | 2018-06-20 |
| 1699147249 | Beth Powell | Peer Specialist | 405 East Excelsior Ave, Vinita, OK 74301 | 2015-10-22 |
| 1023625563 | Steven Ray Coatney | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-09-29 |
| 1932712775 | Karen Tiscareno | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-30 |
| 1669085528 | Felicia Johnson | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-28 |
| 1770108920 | India Leigh Uhlemeyer | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-06-13 |
| 1366062697 | Rylie Bowin | Peer Specialist | 405 E. Excelsior, Vinita Ok 7, Vinita, OK 74301-4226 | 2020-04-16 |
| Find all providers in VINITA | ||||
Please comment or provide details below to improve the information on JAMES RICHARD BROCK.
| 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.