CLIFFORD MERRELL (NPI# 1871027425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871027425 |
| Entity Type | Individual |
| Full Name | CLIFFORD MERRELL |
| Practice Address |
605 E Bellview Dr Midwest City OK 73130-4725 |
| Mailing Address |
Po Box 82785 Oklahoma City OK 73148-0785 |
| Practice Telephone | 4059470200 |
| Practice Fax Number | 4059470202 |
| Mailing Telephone | 4059470200 |
| Mailing Fax Number | 4059470202 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
605 E BELLVIEW DR |
| City | MIDWEST CITY |
| State | OK |
| Zip Code | 73130-4725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059909 | Richard Williams | Behavior Technician | 1121 S. Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-28 |
| 1730794264 | Cassidy Myers | Behavioral Analyst | 1121 South Douglas Boulevard, Suite A, Midwest City, OK 73130 | 2020-09-11 |
| 1831609320 | Progressive Home Health Inc | Home Health | 9070 Harmony Dr Ste C, Midwest City, OK 73130 | 2017-10-10 |
| 1306290903 | Maria Soledad Dabney | Counselor | 9101 Stonegate, Oklahoma City, OK 73130 | 2016-04-20 |
| 1922452804 | Endodontics and Implant Associates,pllc | Dentist | 1621 Midtown Place, Suite B, Midwest City, OK 73130 | 2016-04-18 |
| 1639574130 | Healthcare Express, LLP | Clinic/Center | 1701 S. Douglas Blvd., Midwest City, OK 73130 | 2014-10-27 |
| 1891045274 | Michelle Lynn Goolsby | Behavioral Analyst | 10822 Blue Sky Drive, Midwest City, OK 73130 | 2012-09-13 |
| 1497026173 | Deberry Interprise | Community/Behavioral Health | 9233 North East10th Street, Midwest City, OK 73130 | 2012-01-26 |
| 1245531789 | Nichelle Stewart | Counselor | 10520 Quail Run Road, Midwest City, OK 73130 | 2010-11-16 |
| 1477877835 | Jan Bierne, Inc. | Counselor | 2912 S. Douglas Blvd, Suite A, Midwest City, OK 73130 | 2010-03-15 |
| Find all providers in zip 73130 | ||||
| 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 |
|---|---|---|---|---|
| 1275164113 | Ella Jefferson-speed | Peer Specialist | 3612 Oak Grove Dr, Midwest City, OK 73110-3728 | 2020-01-29 |
| 1083275796 | Aviance Brown | Peer Specialist | 1306 N Midwest Blvd Apt G, Midwest City, OK 73110-3230 | 2019-06-24 |
| 1457819211 | Misty Renea Lowder | Peer Specialist | 1205 N Cottonwood Dr, Midwest City, OK 73130-1721 | 2019-03-11 |
| 1497220545 | Tahisha Bennett | Peer Specialist | 401 N Harr Dr Apt 105, Midwest City, OK 73110-2942 | 2018-10-04 |
| 1962998062 | Ebonye Patrice Clark | Peer Specialist | 1704 Center Dr Apt 2, Midwest City, OK 73110-2869 | 2018-07-02 |
| 1750899100 | Cantrell Eugene Watts | Peer Specialist | 6016 Se 5th St, Midwest City, OK 73110-2250 | 2018-01-19 |
| 1538672498 | Kristen Huntley | Peer Specialist | 2508 Coachlight Dr Apt F, Midwest City, OK 73110-7853 | 2017-11-14 |
| 1548780232 | Stephen H Lutz | Peer Specialist | 2508 S Midwest Blvd, Midwest City, OK 73110-5828 | 2017-06-22 |
| 1861036758 | Happy Itiomemena Ukereti | Peer Specialist | 7117 E Reno Ave, Midwest City, OK 73110-4444 | 2019-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
| City | MIDWEST CITY |
| Zip Code | 73130 |
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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.