KEEGAN EISENHARDT


Address: 6405 S Villa Ave, Oklahoma City, OK 73159-2741
Phone: 4059050285

KEEGAN EISENHARDT (NPI# 1861002818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861002818
Entity Type Individual
Full Name KEEGAN EISENHARDT
Practice Address 6405 S Villa Ave
Oklahoma City
OK 73159-2741
Practice Telephone 4059050285
Mailing Telephone 4059050285
Enumeration Date 2020-08-05
Last Update Date 2020-08-05
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 6405 S VILLA AVE
City OKLAHOMA CITY
State OK
Zip Code 73159-2741

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346849528 Mel Vision LLC Optometrist 1413 W Interstate 240 Service Rd, Suite E, Oklahoma City, OK 73159 2020-10-20
1053959247 Phillip J Elassal Dds Pllc Clinic/Center 1601 Sw 89th Street #g500, Oklahoma City, OK 73159 2019-12-18
1629573407 Carrie Lynn Sanchez Case Manager/Care Coordinator 2604 Sw 92nd Street, Oklahoma City, OK 73159 2018-03-26
1407368038 Deborah Dorton Psychologist Okc Va Hcs (111a), 921 Ne 13th St, Oklahoma City, OK 73159 2017-11-06
1366969933 Matthew Lewis Hearne Case Manager/Care Coordinator 7504 S Country Club Dr, Apt 105, Oklahoma City, OK 73159 2017-08-24
1043766405 Pro Hearing, LLC Clinic/Center 10404 S Pennsylvania Ave, Oklahoma City, OK 73159 2016-08-26
1952764169 Doc LLC Orthopaedic Surgery 3130 Sw 89th St Ste 200e, Oklahoma City, OK 73159 2016-04-04
1235511288 Anusha Koneru Dentist 1610 W Interstate 240 Service Road, Oklahoma City, OK 73159 2015-06-26
1114347069 Crystal A Dockery Family Medicine 3212 Sw 89th St Ste 100, Oklahoma City, OK 73159 2014-04-18
1790121440 Kimberly Anne Dyer Occupational Therapy Assistant 5725 S Ross, Oklahoma City, OK 73159 2013-05-21
Find all providers in zip 73159

Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1023652377 Pamela Kristine Cavazos Peer Specialist 1116 Sw 128th St, Oklahoma City, OK 73170-6954 2019-10-30
Find all providers in OKLAHOMA CITY

Competitor

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City OKLAHOMA CITY
Zip Code 73159

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Dataset Information

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.

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