NPIMap

Individual provider Active NPI

Gay Lynn Peterson

  • Addiction (Substance Use Disorder) Counselor
  • Okmulgee, OK
National Provider Identifier
1023214038
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
323 W 6TH St
Okmulgee, OK 74447-5019
Phone
(918) 756-9250
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

323 W 6TH St
Okmulgee, OK 74447-5019

Mailing address

1116 S Florida Ave
Okmulgee, OK 74447-6200
Phone (918) 756-4512

Other identifiers 1

IdentifierTypeStateIssuer
300522336OtherOKMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260603003370 OK Practitioner - Mental Health Counselor 6800154303 Reassigns benefits to 1 organization
I20260603003489 TX Practitioner - Mental Health Counselor 6800154303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

1800 E Coplin St
Creek Nation Community Hospital
Okemah, OK 74859-4642
Phone (918) 623-1424

Hospital & facility affiliations

  • Creek Nation Community Hospital Hospital, Okemah, OK, CCN 371333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1023214038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 S FLORIDA AVE",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476200",
            "telephone_number": "918-756-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W 6TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744475019",
            "telephone_number": "918-756-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GAY",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "300522336",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okmulgee, OK

Sources for this page

Verify at the official NPI Registry.