AUDRA MICHELLE YADACK (NPI# 1851611602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851611602 |
Entity Type | Individual |
Full Name | AUDRA MICHELLE YADACK |
Other Name | AUDRA MICHELLE WENDT |
Credential | M.D. |
Practice Address |
4601 N Classen Blvd Oklahoma City OK 73118-4815 |
Mailing Address |
450 Clarkson Ave. Suny Downstate Medical Center Department of Psychiatry and Behavioral Sciences New York City NY 11203 |
Practice Telephone | 4058409999 |
Practice Fax Number | 4058409998 |
Mailing Telephone | 7182702902 |
Enumeration Date | 2010-06-03 |
Last Update Date | 2016-12-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
32083 | OK | Allopathic & Osteopathic Physicians |
Street Address |
4601 N CLASSEN BLVD |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73118-4815 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154305928 | Giang Binh Pham | Dentist | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2005-12-05 |
1992063085 | Cynthia G. Barnard | Social Worker | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2012-04-26 |
1174742779 | Sydney Bright Warren | Social Worker | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2007-04-24 |
1174742597 | Shantharam Darbe M D P C | Psychiatry & Neurology | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2007-04-24 |
1871561027 | Ernest Edward Beckham | Psychologist | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2006-03-14 |
1982677654 | Gilberto Castillo Torres | Physician Assistant | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2006-02-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255812772 | Karrie Danea Moreno | Behavior Technician | 1507 Ne 31st, Oklahoma, OK 73118 | 2018-08-23 |
1528578499 | Revive Medical LLC | General Practice | 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118 | 2017-10-05 |
1225556228 | Anika Carr | Case Manager/Care Coordinator | 1212 Nw 32nd Street, Oklahoma City, OK 73118 | 2017-08-30 |
1740635168 | Nikhil Malhotra | Internal Medicine | 3635 Vista Avenue At Grand Boulevard, 14th Floor, Desloge Towers, St. Louis, MO 73118 | 2016-05-04 |
1144694183 | Christopher Woon | Counselor | 4001 N Classen, Suite 105, Oklahoma City, OK 73118 | 2015-11-13 |
1699181925 | Stac Embry | Counselor | 3321 N. Mckinley Ave, Oklahoma City, OK 73118 | 2014-07-08 |
1194161216 | Jennifer Kaye Powers | Counselor | 3124 N. Classen Blvd., Ste. A, Oklahoma City, OK 73118 | 2013-05-15 |
1932445491 | Jessica Camp | Behavioral Analyst | 3220 N Harvey Pkwy, Oklahoma City, OK 73118 | 2013-01-02 |
1942578661 | Michael D Danielson | Behavioral Analyst | 4232 N Sante Fe Ave, Oklahoma City, OK 73118 | 2011-12-08 |
1912280587 | Tara Roberts | Counselor | 1743 Nw 37th, Oklahoma City, OK 73118 | 2011-09-21 |
Find all providers in zip 73118 |
Taxonomy Code | 2084P0805X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Geriatric Psychiatry |
Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265514715 | Donna Fenton Gibson | Psychiatry & Neurology | 2501 Cummings Dr, Oklahoma City, OK 73107-2108 | 2006-10-20 |
1639343650 | Psychiatric Health Corporation | Psychiatry & Neurology | 10101 S Pennsylvania Ave, Suite A, Oklahoma City, OK 73159-6929 | 2008-04-22 |
1730260084 | Charles J Alexis | Psychiatry & Neurology | 921 Ne 13th St, Oklahoma City, OK 73104-5007 | 2006-10-17 |
1124052089 | John C. Andrus | Psychiatry & Neurology | 5100 N Brookline Ave, 950, Oklahoma City, OK 73112-3623 | 2006-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003209057 | Psydoc LLC | Psychiatry & Neurology | 309 N Redbud Ave, Broken Arrow, OK 74012-2376 | 2015-03-16 |
1255591392 | Gs Medical Consultants Inc | Psychiatry & Neurology | 2805 S Bryant Ave, Suite A, Edmond, OK 73013-6159 | 2008-06-12 |
1114011764 | Kirsten Matthews Wilkins | Psychiatry & Neurology | 4502 E 41st St, Dept of Psychiatry, Tulsa, OK 74135-9923 | 2006-10-03 |
1518903764 | Ernest George Shadid | Psychiatry & Neurology | 3280 Marshall Ave, Norman, OK 73072-8028 | 2006-06-22 |
1134199250 | Jimmie D Mcadams Jr. | Psychiatry & Neurology | 6655 S Yale Ave, Laureate Psychiatric Clinic and Hospital, Tulsa, OK 74136-3326 | 2006-01-23 |
1629052808 | Patricia A. Costner | Psychiatry & Neurology | 6655 S Yale Ave, Laureate Psychiatric Clinic and Hospital, Tulsa, OK 74136-3326 | 2005-12-01 |
City | OKLAHOMA CITY |
Zip Code | 73118 |
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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.