NPIMap

Organization Active NPI

Providence Service Corporation of Oklahoma

  • Case Management Agency
  • Durant, OK
National Provider Identifier
1003958091
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PROVIDENCE SERVICE CORPORATION OF OKLAHOMA
Practice address
134 N 12TH Ave
Durant, OK 74701-4718
Phone
(580) 924-6363
Fax
(580) 924-0379
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Breeann Hoerning
Title
Ar Billing Manager
Phone
(520) 747-6694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

134 N 12TH Ave
Durant, OK 74701-4718

Mailing address

620 N Craycroft Rd
Tucson, AZ 85711-1448
Phone (520) 747-6694

National Provider Directory

National Provider Directory
Tax ID family
Providence Service Corporation of Oklahoma15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003958091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111448",
            "telephone_number": "520-747-6694",
            "fax_number": "520-747-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N 12TH AVE",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747014718",
            "telephone_number": "580-924-6363",
            "fax_number": "580-924-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SERVICE CORPORATION OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOERNING",
        "authorized_official_first_name": "BREEANN",
        "authorized_official_title_or_position": "AR BILLING MANAGER",
        "authorized_official_telephone_number": "520-747-6694"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.